Workshop Registration Form

AMIDEAST

Start Your Own Business
April 1 – July 8, 2015
15 sessions: Every Wednesday evening 6 -9 pm
$ 600

Participant Information

Name:	Home Address:
Company Name:	Home Phone:
Title:	Mobile Phone:
Website:	Work Phone:
Education: Degree & Year	Email:
In which sector do you want to start a business?
Please list any professional associations, groups, clubs, or organizations you belong to:

Preferred Social Networking Site: Facebook

Do you have access to an internet connection with a speed of at least 512 Kbps? YES

English Proficiency:

Speaking: Click here to choose	Reading: Click here to choose	Writing: Click here to choose

Payment Details

Workshop Selection	Payment to be made:	Method of Payment:

Signature: _____________________________________ Date: ___________________________

To reserve your place, please submit this form by fax or email no later than March 24.

Your registration will be complete upon finalizing the payment at AMIDEAST:

Bazerkan Bldg, 1st floor, Nijmeh Square, Riad El Solh St. Beirut Downtown

Telephone: +961 1 989901 ext: 234

Fax: +961 1 989901 ext: 100

Email: ajerab@amideast.org

Website: www.amideast.org/lebanon