Registration
Jackrabbit Beyond the Basics Training - Chicago, IL.
Sunday, June 11th from 9:00am - 4:30pm
Location:
Holiday Inn Chicago O'Hare
5615 North Cumberland Avenue
Chicago, IL 60631
Important: Please answer ALL questions under Questions/Options.
Please list your organization's main contact in the Contact section and list EVERY attendee in the Student Section. You may leave the gender and birthdate field blank for every attendee.
Event:
Start Date/Time:
End Date/Time:
Fee per Student:
Room:
*
- denotes required fields
Organization Contact
First Name:
*
Last Name:
*
Home Phone:
Cell #:
Work #:
Email:
*
(Emails are kept confidential)
Address:
*
City:
*
State/Prov:
*
Postal Code:
*
Students entered below will be added to your family's account
Add New Student #1:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Birth Date:
(format=mm/dd/yyyy)
Individual Email Address:
*
Attending Day 1:
*
Attending Day 2:
*
Add New Student #2:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Birth Date:
(format=mm/dd/yyyy)
Individual Email Address:
*
Attending Day 1:
*
Attending Day 2:
*
Add New Student #3:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Birth Date:
(format=mm/dd/yyyy)
Individual Email Address:
*
Attending Day 1:
*
Attending Day 2:
*
Add New Student #4:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Birth Date:
(format=mm/dd/yyyy)
Individual Email Address:
*
Attending Day 1:
*
Attending Day 2:
*
Add New Student #5:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Birth Date:
(format=mm/dd/yyyy)
Individual Email Address:
*
Attending Day 1:
*
Attending Day 2:
*
Questions/Options:
Organization/ Business Name?
*
Type of Business?
*
Please list month and year your Organization / Business started using Jackrabbit.
*
What knowledge do you hope to gain from this training?
Please list all learning tools you have used prior to this training... Online Training Videos, Training Webinars, Help Center, other Classroom Training?
*
Please confirm the total number of attendees from your organization.
*
Promotion code
Additional Information:
$45 Fee per Attendee
(Show-Hide Details)
I understand there is a $45 fee per attendee.
I've read the above and agree.
Payment
(Show-Hide Details)
I understand the total amount due will be processed immediately.
I've read the above and agree.
Cancellation
(Show-Hide Details)
I understand that it is my responsibility to notify Jackrabbit by emailing nkludt@jackrabbittech.com...PRIOR TO 14 DAYS BEFORE THE EVENT... if there is a need to cancel this reservation.
I've read the above and agree.
Enter your Full Name:
*
Other Questions/Comments:
Credit Card Verification:
Card Number:
*
Visa
Mastercard
Amex
Discover
Name as it appears on card:
*
Nickname:
Card Expiration Month:
*
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Exp Year:
*
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Address Line 1:
Address Line 2:
City:
State/Prov:
Postal Code:
*
Please Wait...
