Company Name:
NOTIFIER Account Number
Country:
State:
Postal Code:
City:
Conatct First Name:
Contact Last Name:
Contact Phone Number:
Contact Person Email Address:
Select Training Date:
Certification Requested:
Attendee Names (List all Names)
Attendee Email Addresses (List All):
Purchase Order #
NOTE: 1 unit of BDA-HANDSONTRN-BDA ($250 tuition /technician) for BDA Hands-on, 1 unit of BDA-HANDSONTRN-FIB ($250 tuition/technician) for Fiber DAS Hands-on(Maximum 4 technicians can attend hands-on together from the same location) - REQUIRED FOR BILLING OF TRAINING.
GROL TRAINING Purchase Order #
NOTE: Purchase Order for 1 unit of BDA-GROL-TRAINING for $995.00 for each participant- REQUIRED FOR BILLING OF GROL TRAINING
GROL Attendee Names (List all Names)
Do any of the attendees have a FCC GROL License
NOTE: FCC GROL is not required for registration or to attend technical training, however, GROL license is required for at least one of the factory certified BDA / Fiber DAS technicians before the BDA / Fiber DAS product can be purchased.
Provide FCC GROL License Number(s):
Entitlement Programs:
Person Source:
GBE (L):
Division:
GBE (C):
SBG (L):
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