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First Name*
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Middle Initial
 
Last Name*
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PMI ID Number*
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Company Name
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Course Purchaser
if different than person submitting
 
E-Mail Address*
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Confirm E-Mail Address*
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Contact Phone Number*
(123) 555-1212

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How did you find out about PMT
and our training programs?
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Course Completed*
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PDUs Requested*
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The PMT Receipt & License Number
  For verificaition of purchase
Approximate course start date* (MM/DD/YYYY)
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Approximate course end date* (MM/DD/YYYY)
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Approximate number of hours to complete course*
  Please approximate the hours it took to complete the course

If you have any questions, comments, or concerns

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Course Questionnaire
1= Not Satisfied, 5= Very Satisfied
Rate the course content
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Rate the course format
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Rate how the course met your educational needs
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We welcome any additional comments!
 
   
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(All required fields & questionnaire must be filled in)

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