AutoAudit® Training Workshops & Consultations Use the form below to order your participation passes for AutoAudit® Desktop training workshops and consultation hours purchases. 1About You2Workshop Selections3Agreement URLThis field is for validation purposes and should be left unchanged.Name(Required) First Last Company/Organization Name(Required)Email Address(Required) Enter Email Confirm Email Company/Organization Billing Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Phone Number(Required) Which workshop would you like to join? 16 Hour Virtual Training Workshop 8 Hour Reporting Workshop Up to 4 Hours – Installation/Upgrade Services 16 Hour Virtual Training Workshop SeatsAll pricing below is per person.AutoAudit® Training Workshop Seats (Pricing is per person) Quantity(Required) Price: $1,250.00 Quantity This is for the 16 hour virtual training workshop. Select your workshop date(Required) February 18 – 21, 2025 May 12, 13, 15, & 16, 2025 September 16 – 19, 2025 November 11 – 14, 2025 Six (6) registered participants are required to register or the workshop will be cancelled. Note: This is NOT the minimum number you must register, but the minimum number of participants from all customers attending.8 Hour Reporting Workshop SeatsAll pricing below is per person.AutoAudit® Reporting Workshop Seats (Pricing per person) Quantity(Required) Price: $900.00 Quantity This a virtual workshop.Select your workshop date(Required) March 12 – 13, 2025 September 23 – 24, 2025 Six (6) registered participants are required to register or the workshop will be cancelled. Note: This is NOT the minimum number you must register, but the minimum number of participants from all customers attending.Install/Upgrade ServicesInstallation/Upgrade Services Quantity(Required) Price: $1,500.00 Quantity Up to 4 hours is included in the price. Six (6) registered participants are required or the workshop will be cancelled.Total and PaymentTotal to be paid Promotional CodeProvided to you directly by a Solutions Expert or Customer Experience team member.Credit Card(Required) American ExpressDiscoverMasterCardVisaJCBSupported Credit Cards: American Express, Discover, MasterCard, Visa, JCB Card Number Expiration Date Month Month010203040506070809101112 Year Year20262027202820292030203120322033203420352036203720382039204020412042204320442045 Security Code Cardholder Name By clicking submit below you agree to the Payment Terms and Conditions as well as the Cancellation Policy as outline below. This is a legally binding agreement. CANCELLATION POLICYOnce you provide written confirmation of your training, the following Cancellation Policy is in effect. Rescheduled classes must be completed within three months from the date of the original class. All cancellation notices must be submitted via e-mail to your Empowered Systems Project Manager. Empowered Systems reserves the right to cancel, reschedule or change the location of workshops up to 21 business days prior to the scheduled workshop date. The option to receive a full refund for the session price or participate in a future workshop will be presented in this case. Empowered Systems will not be responsible for any travel costs incurred due to a workshop session reschedule.Electronic Signature(Required)This format complies with the US E-SIGN Act and you are acknowledging that you’re acting as an authorized representative of your organization or company.Date(Required) MM slash DD slash YYYY