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APPLICATION

I would like to start your program right away, so that I can be registered and start

assembling your boards as soon as possible. Enclosed is my full payment of $ 48.90 (non

refundable).

Enclosed is my partial payment of $ 19.00. I would like to examine your electronic

components. If I feel like this is not for me, I can send the complete kit for refund less $ 6.75

postage, handling and inspection charges with no question asked.

Choose one bellow

Application form

My Products*
Full registration fee $48.90 USD
Partial reg fee $19.00 USD

Full Name*
First Name Last Name

E-mail

Address*

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

It is understood by the parties that you arel an independent contractor with respect to Electronic Lab, and not an employee of Electronic Lab. Electronic Lab will not provide fringe benefits, including liability, workman’s compensation, health insurance benefits, paid vacation, or any other employee benefit. You are responsible for your oun taxes.

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Electronic Laboratories

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