Diversity Training University International

Diversity Trainer/Consultant Referral Signup

The information that you input below will be used to provide a way for site visitors and members to find you. Please be sure to make correct entries to ensure that your information is accurate. You will be provided a username and password by email.

Search The Current Referral Network HERE

Join Diversity Training University International and/or Sign Up for our Diversity Trainer Referral Service here.
What Are The Benefits?

Fee For Service
Hourly:
Daily:
Weekly:
Monthly:

Professional References
#1- First & Last Name:
	Title:
	Organization:
	Phone #:
	Email:

#2- First & Last Name:
	Title:
	Organization:
	Phone #:
	Email:

Account Setup
Input your desired username below. NOTE: If the username you select is already taken, you will be asked to select another after clicking the submit button.
*Username:

Personal Information * Indicates field is required to process your registration
* First Name:
* Last Name:
* Company:
Title:

* Address 1:
Address 2:
* City:
* State/Province:
* Country:
* Zip:
* Email:
* Website:

* Day phone:	( )
Evening phone:	( )
Fax number:	( )

* Birthdate:	- -
* Gender:
Race/Ethnicity: -- This information is to account for how well DTUI is servicing a cross-population of trainers and consultants.	if other:

Background
Occupation:
Degrees:
if other, list here

Experience:
# of Years:
if other, list here

Use the space below to provide additional information about your background. e.g., accountant, university professor, manager, CEO, etc.

Additional Information May Be Required, Please click here For More Information.

All Funds Are US: Please make any foreign currency adjustments. Membership is for one full year from your date of registration:

Membership is free for current DTUI trainees. New members can sign up to receive an extra SIX MONTHS for FREE. That's 1 ½ years of referral service for the price of one year. A password is provided upon receipt of application form. It is needed to enter your profile in the website that is also provided.

Go to DTUI Trainer Referral Service for examples of profiles.

I am signing up for:
$300.00 US for Diversity Training University International graduates only.
$495.00 US for Trainer Referral Service Listing.
$450.00 US Renew DTUI Trainer Referral Service Listing.

Form of Payment:
The DTUI website is on a secure server which means your credit card information will be safely encrypted (Your card will be processed by Diversity Training University International and will appear on your statement as payment to DTUI).

If paying by credit card, we accept American Express, Visa, Master Card and Discover***

Card Type: Card #:
Exp. Date: MM / YY
Name on Card:

All participants in the DTUI Referral Service are expected to acknowledge having read the DTUI Standards and Pledge (Click here to read). Once you have read them, simply backspace to return to this page to continue.

By submitting this form, you are indicating that you have read the DTUI Standards and Pledge.

If you prefer, you may also print this form and fax it to (858) 615-2055 with your credit card information for immediate processing.

If you choose to pay by check and submit your membership via postal mail, make sure that your check is payable to Diversity Training University International, and that your check is payable in U.S. funds from a U.S. bank. Wire transfers are not acceptable for payment.

DTUI Referral Service Registration PO Box 720207 San Diego, California, 92172-0207, USA

We will confirm receipt by mail or e-mail.

***Refunds: Requests for refunds or our refund policy must be submitted in writing.

Diversity Training University International
PO Box 720207 San Diego, California 92172-0207 or (858) 672-2654 admin@dtui.com