REFUNDS &
CANCELLATION POLICY
© 2006 Victory Infusion Consultants, Inc.
Victory Infusion Consultants, LLC
777 South Ham Lane; Suite D, Lodi, CA 95242
866-971-VICC (8422), 209.334.9400, FAX: 209.334.9402
Peripherally Inserted Central Catheters (PICCs)
PICC-Midline | Vascular Access Training
First Name*:
Last Name*:
Address*:
City*:
State*:
Zip*:
Telephone(s)*:
E-Mail*:
Name of Class*:
Date of Class*:
1st Choice
Date of Class:
2nd Choice
Professional License#*:
Please Check One*:
* Required
8 REGISTRATION FORM: CLASSES