Name
Title
Organization
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
Home Phone
FAX
E-mail
URL

Class options:

Please select the PC Potential class or service offering below.
	PC Prime company specific training.
Please describe the training required
	PC Foundations computer fundamentals training
	Microsoft Word
	Microsoft Excel
	Microsoft Power Point
	Microsoft Outlook
	Microsoft Access
	Microsoft Front Page
	Quickbooks
	Entrepreneurship Series Are you an entrepreneur? Business Financing Legal Structures Marketing Selling Working Efficiently Human Resources Accounting and Financial Analysis Business Plan Writing Workshop Business Plan Presentation Session
	Professional presentations and public speaking
	Marketing for small business
	Web design
	Direct e-mail marketing services
	Template design for Word, Excel, Power Point or e-mails

BILLING
Payment is due at the time of registration.
We will be happy to invoice you but payment is
required within 5 days of the class date.  Cancellation
penalties apply.
If a purchase order number is required, please provide
here.
If paying by credit card, please provide card information
here
Credit Card	VISA MasterCard
Cardholder Name
Card Number
Expiration Date

What are your preferences for training locations?

Our 6 seat training lab  Onsite at your business.                                     

What are your preferences for training times?

Full days during workweek Full days Saturday  Mornings Afternoons Evenings 

        Please add any additional requirements or requests.

Please PRINT the completed form and return

by fax to 985-851-4052

by mail to PC Potential, 122 New Orleans Blvd, Houma, LA 70364

by e-mail attachment to cgaiennie@pcpotential.com