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Application Form 2013-14

Course Dates: 1st Session: 05 09 May 2014, 2nd Session: 31 Aug 04 Sept 2014 Participant Personal Details
First Name: Last Name: Email: Member of the AALZ Alumni family? Mastership Master Other please specify Date of Birth: Current Address: Town: County: Postal Code:

Phone:

Clinic Details
Clinic Name: Position: Phone: Town: E-mail: County: Title: Address: Fax: Postal Code:

Payment Options:
Course Fee: Payment Type: Standard: 7500 Paypal Early Bird: 7000 AALZ Alumni family 6500

Goals:
Which goals do you wish this program to fulfil?

Dental Practise

Own Business

Public Sector

Consulting

Assets:
Which assets of this program are more vital for you? HRM Marketing Communication Skills Accounting Economics Business Plan Leadership Skills Negotiation Skills Other Consumer Behaviour Presentation Skills

Other Info:
Class sizes will be of a minimum of 15 to a maximum of 25 people per class. A laptop is required from all participants to bring to course in order to follow the flow and minutes of the course.

Signature of Applicant:

Date:

Terms & Conditions: Cancellation Policy: In order to receive full refund of course fees, cancellation notice must be send at least 30 days prior to the start dates of the course. AALZ - RWTH AACHEN University Campus reserves the rights to change dates or location of program without further notice. Audio or video taping of any kind will NOT be allowed from participants during the course. Course Fee Agreement: In order for the participant to guarantee their participation to the course 1/2 of the amount must be paid on the registration date. An invoice will be issued upon receipt of registration form and send to the participant. Early bird fee applies up to 3 months before the scheduled start date of the course. Personal Data Protection: AALZ - RWTH AACHEN University Campus is responsible for the protection of your personal data. Your information and personal contact details are used in order to keep you informed of courses and conferences that might interest you. Your personal details will not be used by any other bodies or for other purposes. If you do not wish to receive such information please note here

Accommodation Options:

Option A: Hotel: Rate: Walking Distance: Option B: Hotel: Rate: Walking Distance: Option C: Hotel: Rate: Walking Distance: Option D: Hotel: Rate: Walking Distance: Category: Category: Category: Category:

*All accommodation options have been carefully selected and designed especially for this program and guarantee the best accommodation rates within walking distance for conference facilities.
(The above document will be forwarded to every candidate with 4 different hotel options with completion of application process)