BioTrace - QRA Registration Form

Registration for QRA, the practice changing training event of 2012!
Spaces are limited, don't miss it! (See form below)

The QRA 2012 courses have been confirmed for February. International trainers Matt Storey & HR Payne from Premier Research Labs, Texas will be here to run the level I, II & Mastery courses in Auckland. Matt and HR bring exceptional professionalism and personal experience to their training with a tremendous wealth of knowledge.

REFUND POLICY: Refunds will not be available after February 3rd 2012 due to booking & catering requirements.

FULL PAYMENT DEADLINE: Full course fees will be charged upon registration since we have passed the payment deadline, 3rd February.

NOTE: Student space allocation is extremely limited. There is a possibility that your application will not be accepted. If it is determined that we cannot accommodate you on any given course, you will receive a full refund.

Repeat Attendee Special: If you have attended a course previously and wish to polish up your QRA skills, you can repeat the same course for a 15% discount!

Please complete the following registration form to apply (NZ ONLY) Click here for Australia QRA info

NOTE: A $50 non-refundable deposit applies and will be charged to the credit card supplied upon registration - counts toward total course fees. This deposit may not be placed on account.

Click here for course details

Name:			*
Email:			*
Practice Name:
Student:	Yes No ID No. Expiry
Postal Address:			*
Phone:			*
Practitioner Qualifications: Or current training level			*
Select the courses you wish to attend:	QRA - Level I (NZ)	Yes No
	QRA - Level II (NZ)	Yes No
	QRA - Mastery (NZ)	Yes No

Previously attended courses: If applicable	QRA - Level I (NZ)	Yes No
	QRA - Level II (NZ)	Yes No
	QRA - Mastery (NZ)	Yes No
Credit Card No: Visa or Mastercard	Expiry Note: Full course fees will be charged upon registration since we have passed the payment deadline, 3rd February. Please call 09 570 5923 if you wish to discuss payment options.
Where did you hear about QRA? Additional Notes:
	Fields marked with * are required.

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