Becoming A Human Relations Professional Sign-up Form

You are on your way to enjoying the benefits of becoming a diversity expert. Please fill out the short form below to get started. A counselor or faculty person will contact you within 24 hours (Monday-Friday) to work closely with you in your course plan and accessing the first course. It is easy as that.

Sign up today and receive a BONUS offer of a FREE Diversity Training Referral Service listing. This enables visitors to DTUI's website to find you in the Diversity Trainer database. Members find it a valuable resource for obtaining both local and national contracts (That's a $495.00 value). Your listing can actually pay for the course with one consultation/training.

First Name:
Last Name:
Company Name:
Address:
Address:
Suite/Apt:
City:
State/Province:
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Fax:
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Present Occupation:
Birth Date:
Referred By:
Password: (Last 4 Digits of Soc. Sec. #)

Comments:

Payment Options:

SPECIAL Single Course Offer - $475.00 [Regularly $700.00 - That's a savings of $225.00] (State course of interest in "Comments" box above)

Sign up for a program to receive huge savings and FREE placement in the Diversity Trainer Referral Service ($495.00 value).

BASIC DIVERSITY TRAINER SKILLS CERTIFICATE PROGRAM

Basic Diversity Trainer Skills Certificate Program - Pay $5300.00

Basic Diversity Trainer Skills Certificate Program (EXTENDED PLAN)- Pay $995.00 Now and 12 Payments of $400.00

MASTER DEGREE IN CULTURE & ORGANIZATIONAL BEHAVIOR

Masters Degree in Culture & Organizational Behavior- Pay $8800.00

Masters Degree in Culture & Organizational Behavior (EXTENDED PLAN) - Pay $995.00 Now and 10 payments of $700.00

Credit Card Check or Money Order Credit Card Information (Your card will be processed by Diversity Training University International and will appear on your statement as payment to DTUI):

Payment Method:	Visa MasterCard American Express Discover
Credit Card #:
Credit Card Expiration Date:
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Name on Card:

VERISIGN PROTECTED FOR ADDED SECURITY

Please Note:   Sorry, but we cannot process your application until your tuition is received.

NOTE: We accept VISA, MasterCard, American Express or Discover. Credit card information is not needed if paying in full by check. If you want to pay by credit card please FAX 888.505-2471 or phone 415.896-5300 your credit card number and expiration date.

Note: You may also print this order form and fax it to 888.505-2471 if you prefer.

Diversity Training University International
Admissions & Registrars Office
415-896-5300 admin@dtui.com
55 New Montgomery Street, Suite 513
San Francisco, California. 94105
USA

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