ATAE, Inc. Registration / Enrollment Agreement Please print and mail this registration form: 13899 Biscayne Blvd. / North Miami, FL. 33181/ 305.756.1765

Identification Information:

Name: (last)_________________________________ (first)___________________ 

Address: ________________________________ Apt. No.: ___________

City: ___________________ State: _______ Zip: ____________ County: _____________

Home Phone: _______________________  Mobile Phone: ___________________________

Work: ______________________________ Email: _________________________________

Name of Business: (if applicable)________________________________________________

Course and Payment:

Course Title: ___________________________________ Course Hours: ____________

Day(s) attending: __________________________ Time: ____________________ 

In consideration of ATAE, Inc.’s acceptance of my registration / enrollment, I agree to pay 
A.T.A.E, Inc. $____________________ for the above named training.

Refund Policy:

1. No refund will be given 48 hours or less prior to class.
2. No refund will be given to students who pay and do not attend the class.
3. If you do not attend the scheduled course you registered for, you can attend another training at A.T.A.E.,Inc. schedule of that training.

________________________________________ _____/____/_____
Signature of Participant Date

Payment Type:

___ Cash ___Check: Number_______ ____Money Order ____ Credit Card ____ Debit Card

__Master Card __Visa __Am Ex __ Discover __Other: ______________

Write legibly

Credit Card Number


Expiration Date 


Security Number (This Number is on the back of your credit / debit card)
American Express card holders enter 4-digit security code on the front of your card.

__________________________________________________________ _______/_______/_______
Authorization Signature of Card Holder Date