Business and Educational Outreach

UC Clermont Park 50 TechneCenter

 

Registration Form
Since we are currently using a non-secure server, please print out the following form. If you would like to pay by credit card information, please fax this form to (513) 248-5535. To send a check or money order, please send to: UC Clermont Park 50 TechneCenter, 502-G Technecenter Drive, Milford, OH 45150. If you have any questions, call us at (513) 248-5532.
Course of Interest:
Name:
Street Address:
City:
State:
Zip Code:
Home Phone:
Work Phone:
Email Address:
Method of Payment:
Visa Discover Money Order
MasterCard Check
Name as it appears on card:
Card #:
Expiration Date:
Comments:
502-G TechneCenter Drive| Milford, Ohio 45150
(513) 248-5532 | Fax (513) 248-5535