Registration


 


First Name:
Last Name:
RN/LPN
Technician
Biomedical personnel
Other
Email:
Facility:
Facility Address:  
Suite:
City:  
State:
ZIP:
FAX:
Phone:
   
Payment Method:  
Service Contract Number:
Credit Card
PO Number
If you are not under an Olympus Service Contract, our education coordinator will contact you to complete your credit card transaction or you can call 1-800-231-0016 to do so at your convenience.
* To confirm your attendance and contact hour registration, payment is due upon the completion and submission of the electronic registration form. Failure to pay may result in forfeiture of contact hours. Unpaid fees will be recorded and reported to the appropriate accreditation board.
To assess your need in this training, please tell us what equipment you are most interested in to enhance your knowledge.
Hold Ctl to select more than one value.
What are your expectations from this training?
   
Yes, I would like to receive e-mail from Olympus in the future about special announcements, new products and services, upcoming events and other important news.
   
I acknowledge that participation in Olympus University courses and programs are NOT contingent upon any purchasing obligations from Olympus.


To continue submitting your registration through our secure server, please click 'Proceed' below.