Service March 2013 .Net Office Home Application

Location:

Posted:

January 30, 2013

(Print Neatly)

LAST NAME FIRST NAME M.I.

Current Address:

City: State: Zip Code:

Home Phone : Cell/Beeper : Area Code Number Area Code Number

* *.*.-2 p.m.; 2p.m.-10 p.m.; 10 p.m.-6 a.m; (Other)

Email: Shift Currently Working:

Regular Days Off:

Name of Institution: Rank testing for: Major

Institution phone number:

Please remit by Postal Money Order ONLY! Purchase the money order at any US Post Office.

Richard C. Groth

Made payable to:

(SAME LOW PRICE FOR THE LAST SIX YEARS)

(Check One)

Discount Tuition: $745.00 (Early registration discount fee if I receive payment prior to 1/1/2013)

Regular Tuition: $795.00 (If payment is received on 01/1/2013 but before the course starts on Mon., 1/7/13)

Late Tuition: $895.00 (If received after the course starts)

In order to reserve space, your application and payment should be received by January 1, 2013.

Enrollment is limited due to space. Don t miss out!

I understand that attending this course only prepares students for the upcoming NJDOC Majors

Promotional Exam administered by the NJ Civil Service Commission (CSC) formerly the DOP and tentatively

scheduled to be given in March 2013. Changes in the actual test or test date are controlled by the CSC. The

training is based upon the information provided to all candidates and changes are possible. The tuition paid is

strictly to prepare you for that exam as announced and scheduled. Changes by the CSC are uncontrollable. All

students must sign an agreement the first day of class regarding course policies and procedures. No video or

recording devices are allowed. Cell phones and pagers must be on vibrate or left in you vehicle. Both your

valid drivers license and photo work identification card are required for admission to all classes. The course

will start on Monday, January 7, 2013. No additional correspondence will be mailed to you. There will be no

make-up classes available for those who miss any class. There will be absolutely no refunds available for any

reason. Call 609-***-**** or email me at ******@*********.*** if you have any questions. Your signature

below indicates that you understand and agree to the details written in this form.

Date: Signature:

Return to Richard C. Groth

NJDOC Majors Promotional Prep Course

P. O. Box 2698

Trenton, NJ 08690-0698 MW/2013 NJDOC Majors Promotional Exam Prep Course Registration Form

This registration form is required. Please return completed form with your payment