Pharmaceutical Training Seminars, Inc.
(A Division of Jeiven Pharmaceutical Consulting, Inc.)
6 Jacobs Lane
Scotch Plains, NJ 07076
Tel: 908-233-4508
Fax: 908-654-4829

  
 

Print this form out, fill out the information and fax to the number above

Course to Attend *
First Name *
Last Name *
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Years in Position
Company or Organization *
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Fax *
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CE Credits Required?
Payment Options (Invoice your company OR Mail in check to JPC)
Any Comments Appreciated

Print this page and fax to: 908-654-4829