TRAINING AND ACCREDITATION PROGRAM
				Order Form

Company Contact:__________________________________________________________________________

Company:__________________________________________________________________________________

Address: _________________________________________________________________________________

City, State, Zip: ________________________________________________________________________

Phone: __________________________________   Fax: _________________________________________

Email: ___________________________________________________________________________________


The Training and Accreditation Program is $100.00 each.  This includes the manual, the 
printed questionnaire and the questionnaire on CD Rom.  


________	Training and Accreditation Program  			$ ________________

		Total							   _______________

Please send a check for the total number ordered or completed below to charge to your 
credit card.

Card #: ___________________________________________  Expiration Date: _________________

Name on card: _____________________________________

Type of card: MC ________  Visa ________  


Name and email address of Employees taking the Training and Accreditation Program:


	1.	____________________________________________________________________________
	
	2.	____________________________________________________________________________
	
	3.	____________________________________________________________________________
	
	4.	____________________________________________________________________________
	
	5.	____________________________________________________________________________

For office use only:

Paid check # _________  cash ________   Date: ________  CC ________ (see above)

Took Program ________  Mail Program ________  (must include payment)


			Helene Cavanaugh
			Executive Director
			13121 Louetta Road #1175
			Cypress, Texas 77429
			1-888-974-2272
			Fax: 866-488-7601
			tapc4u@sbcglobal.net