Norton Audits Fraud Training Class Registration

Training Class Registration Class Name: Detection and Prevention of Fraud and Misconduct Class Dates: 10/19/2006 to 10/20/2006 Please fill in all Shaded Areas, save and email to [email protected]. Or print, fill in and fax this form to 803-233-4819, or mail to address below. Attendee Information: (Education and Experience Levels must meet Class Requirements to facilitate proper learning.) Name: Address 1: Email: Address 2: Organization: City: Phone: ( ) - - State, Zip: Education Level: Certificate Associates Bachelors Masters PhD Education Curriculum: Clinical Research Experience: 0 Year CRA/Monitor Study Coordinator Auditor Regulatory/Quality Assurance Management Clinical Investigator Consultant Other Columbia, SC Classes Held At: Recommended Hotels: Lexington Municipal Center Hampton Inn Holiday Inn Express 111 Maiden Lane 601 Columbia Avenue 131 Innkeeper Drive Lexington, SC 29072 Lexington, SC 29072 Lexington, SC 29072 803-951-4640 803-356-8300 803-808-0800 Travel Recommendations: The Columbia, SC (CAE) airport is 15 minutes from Lexington, SC, and is served by all major airlines. Greenville, SC (GSP) and Charlotte, NC (CLT) airports are both 90 minutes from Lexington. Several restaurants are within walking distance of our training facilities, the Hampton Inn and Holiday Inn Express. A taxi from the Columbia airport to Lexington is approximately $20.00. Rental cars are certainly available. Continuing Education Units: A Norton Audits Training Certificate including Eight Contact Hours per day is provided for each student. Continuing Education Units (approximately 0.8 CEUs per day) are available to students that attend each day, complete course evaluation, checking one type of CEU here and pay an additional $10.00 fee. General CEU Nursing CEU Pharmacy CEU Payments Accepted: Upon acceptance of this Class Registration Form by Norton Audits, Inc., you will be emailed an invoice for the class fee via the PayPal national credit card facility for payment via credit card. Your PayPal receipt is your class confirmation and secures your place in our class of 15 maximum students. Personal checks are not accepted. Corporate checks are accepted and should be made payable to Norton Audits, Inc. Cancellation Policy: Cancellations by attendees at least 14 calendar days prior to the class start date are refunded all class fees minus a $200.00 fee. Norton Audits, Inc. reserves the right to cancel this class at least 7 calendar days prior to the class start date without responsibility for participant’s airfare, hotel or other costs. In the event class is cancelled by Norton Audits, Inc., all participant fees will be transferred to the next scheduled class.

Norton Audits, Inc. 218-B East Main Street Suite 104 Lexington, SC 29072 phone: 803-233-4809 fax: 803-233-4819