Registration Form: Local C.P.M. “Review Sessions”

Name: ______________________________________________________

Employer: ___________________________________________________

Work Phone: ___________________ Home/Cell: ____________________

Email: ______________________________________________________

I Plan on Attending the Following Review Sessions:

[  ] Dec. 6 – Modules 3 & 4 - $35 per Module

*Coffee, Juice, Soda & Lunch is Included

*Review Sessions are held at Fox Valley Technical College

PayPal or Mail Registration & Checks to:

            http://www.new-ism.org/payment.htm

                                    or

                       Jim Schuettplez

                     1971 London Road

                   Green Bay WI  54311

Make Checks Payable to: ISM – Northeast WI, Inc

Questions: Call Jim Schuettpelz @ 920-469-0751

Or

                Jim Wise   jim.wise@plexus.com