Select Your Training ClassWhich class are you registering for? Classes for May are full. Please register for the August class.* June 24th - 25th October 28th - 29th Attendees should plan on arriving Monday afternoon, and plan on leaving Wednesday after 6:00 PM EST or depart Thursday morning. Please let us know when you plan to leave and let us know if attendee(s) will be flying or driving for purposes of transportation.The minimum number of persons attending service school is six (6) and the maximum number is nine (9). The benefits of this are the enhancement of training through the sharing of knowledge and experience as well as ensuring ample time is available for detailed training on topics of interest to the class as a whole. If the minimum attendance requirement is not met, the people scheduled to attend the course will be notified by phone and/or email of cancellation. Based on this criterion, the decision to cancel the course will be made three weeks prior to the scheduled course date. (No reimbursement for plane tickets.)Company InformationPlease provide your company name and address.Customer Number*Company Name or Sponsor*Attendees of Service School must be an existing SAMSON Distributor or sponsored by a SAMSON Service Center.Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Attendee InformationPlease provide name, e-mail address, and telephone number for each attendee. The minimum number of persons attending service school is six (6) and the maximum number is nine (9). Attendee - 1*Name of person attending Service SchoolContact E-mail* Contact Phone*Attendee transportation to/from Weaverville*Do you need transportation to or from the airport or hotel? I will be flying I will be driving I will need transportation from airport I will need transportation to airport Attendee transportation to/from SAMSON*Do you need transportation to or from the hotel to our Weaverville facility? I need a ride to SAMSON I will be driving to SAMSON Dietary RestrictionsPlease note an dietary restrictions you may have. Attendee - 2Name of person attending Service SchoolContact E-mail Contact PhoneAttendee transportation to/from WeavervilleDo you need transportation to or from the airport or hotel? I will be flying I will be driving I will need transportation from airport I will need transportation to airport Attendee transportation to/from SAMSONDo you need transportation to or from the hotel to our Weaverville facility? I need a ride to SAMSON I will be driving to SAMSON Dietary RestrictionsPlease note an dietary restrictions you may have. Attendee - 3Name of person attending Service SchoolContact E-mail Contact PhoneDietary RestrictionsPlease note an dietary restrictions you may have. SAMSON is a smoke-free facility. A purchase order in the amount of $250 for each attendee is required. A deposit of $250 will be required upon registration and can be paid using a purchase order or check. This deposit will be refunded after the attendee completes the Training or if cancellation is received two weeks prior to the scheduled Training date. If the registered person is unable to attend, a substitute may attend in their place to avoid loss of deposit. Samson will cover meals and hotels. Trainee will be responsible for transportation costs. Thank you for taking the time to complete this form.
