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Name Tag PreferenceTitle*Company or Organization Name*Department or Division*Duration*How many years have you been in this position?Responsibilities*Please list your responsibilities in your role.Education*Please describe your educational background, including any degrees attained from colleges or Universities.Company or Organization Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Company or Business Phone*Do you have any special dietary needs or any other special needs?*YesNoDietary / Other Accommodations*Please notify us of any special dietary needs at least 4 weeks before the program begins.Comments or NotesBilling*I will send a check to the address below.Please bill my company.Please bill me directly.Bryan School Business Partner RegistrationVisa or MasterCardPlease choose your billing preference.We will contact you within two (2) business days to request card information.Billing Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSaint MartinSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country You will be contacted by email or phone within 1-2 days to confirm receipt of your registration. Please check to ensure the accuracy of those fields. Cancellation & Refund of Fees: In cases where an accepted candidate becomes unable to participate in the program, refunds/credits of fees will be made according to the following: If written notice of the candidate's withdrawal is received more than 4 weeks prior to the beginning of the program, a full refund or credit will be issued. If notice is received less than 4 weeks prior to the beginning of the program, 75% of the program fee will be refunded or credited. No refunds will be made for participants withdrawing after the program begins. Please send payment or questions to: Pattie Hollinger Executive Education UNCG Bryan School of Business and Economics PO Box 26170 Greensboro, NC 27402-6170 (336) 334-3088 Have a question? View Ms. Pattie Hollinger Program Manager for Executive Education pjhollin@uncg.edu (336) 334-3088 View Mr. Joseph Erba Assistant Dean and Lecturer jrerba@uncg.edu (336) 334-5338
