CAOHC APPROVED COURSES

PLACE: 124 Silver Street, Waterville, Maine. Parking down in church parking lot on right.

	RE-CERTIFICATION COURSE (8 hrs/1 day)	TIME: 8:00 a.m. to 5:10 p.m. *Standard:$250.00
DATE:	April 11, 2011 __________	*Early Bird: $225.00 if postmarked by 3-11-2011 New manual: (optional) $70.00

*includes: tuition, Certification fee (paid to CAOHC), lunch and coffee breaks.

***Please bring your audiometer if you have one.

***Course size is limited to 8 students. Please register early.

REGISTRATION for RE-CERTIFICATION Please fax registration to 207-872-0330

NAME_________________________CERTIFICATION #___________EXP. Date________

NAME OF COMPANY______________________________________________________

ADDRESS_______________________________________________________________

CITY___________________________________STATE_____________ZIP___________

PHONE NUMBER__work:____________________home:___________________cell:_______________________________________ .

EMAIL: work:_______________________________________________home:_____________________________________________

Make checks payable to: Dr. Anne Giroux, Audiologist

PLEASE INDICATE ANY SPECIAL ACCOMMODATIONS / RESTRICTIONS THAT YOU MAY NEED: