Alliant Power Diesel Technician Training Enrollment Form

Alliant Power Diesel Technician Training Enrollment Form

Contact Information
Full Name of Student*

First NameLast Name
Company Name*
PO#*
Position *
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Company Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Prerequisites to Enroll in Alliant Power Courses
Please provide the number of years of experience you have as a diesel technician below.
Are you planning to register another individual for this course? If so, kindly complete the section below designated for additional students.

YesNo

Additional Student(s) Contact Information
Full Name of second Student*

First NameLast Name
Position *
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Please provide the number of years of experience you have as a diesel technician below.
Will you be registering a third student?

YesNo
Full Name of third Student*

First NameLast Name
Position *
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Please provide the number of years of experience you have as a diesel technician below.

Alliant Power Courses

Save big! Here are two ways to get a discount on our courses:

Enroll in both courses today and receive a discount.
Enroll multiple techs for a single course to receive a discount.

Don't miss out! This limited-time promotion is only valid for simultaneous enrollment in both courses or group enrollment in a single course.

Single Class Enrollment:

No. Techs Enrolled	Cost Per Student	Total Cost	Coupon Code
1	$650.00	$650.00	N/A
2	$575.00	$1,150.00	DBLTECH
3	$550.00	$1,650.00	3PTECH

Enroll into Both Classes:

No. Techs Enrolled	Cost Per Student	Total Cost	Coupon Code
1	$600.00	$1,200.00	DBLDIP
2	$525.00	$2,100.00	DBLTECH2
3	$500.00	$3,000.00	TRPTECH2

Please select the course(s) you wish to attend. You must choose at least 1 quantity to register. The Alliant Power Courses are scheduled from 8:00 AM to 4:00 PM CST/MST. If registering for yourself and another student, please select a quantity of 2 for the courses you both wish to attend. If registering for yourself and two other students, please select a quantity of 3 for your desired courses. *

Duramax A to ZCourse Date: Sept, 23-24 | Location: Alliant Power Windsor, WI

$650.00 Quantity
Item subtotal:$0.00

Powerstroke A to ZCourse Date: Sept, 25-26 | Location: Alliant Power Windsor, Wi

$650.00 Quantity
Item subtotal:$0.00

Enter coupon

Total

$0.00

Certificate Delivery
Please fill this section if the delivery address for the certificates is different from the address you enter the contact information.
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please select your t-shirt size*

Travel Accommodations
The participant is responsible for arranging and covering expenses for lodging and transportation for each day of the course. Alliant Power has secured a preferred rate at the designated hotels listed below, conveniently located near our training facilities.

Denver, CO: The specified hotel is approximately a 13-minute drive from the Alliant Power Denver facility. Transportation options such as Uber and Lyft are available for commuting between the hotel and the facility.

Windsor, WI: The specified hotel is just a 10-minute drive from our Windsor, WI training location, providing easy access to the Alliant Power facility in Wisconsin.
Participants are encouraged to plan accordingly to ensure a smooth and comfortable stay.

Hilton Garden Inn Arvada Denver ← Click here to book today!

5455 Olde Wadsworth Blvd

Arvada, CO 80002

303.420.9799

Alliant Power Code: 3261726

DoubleTree by Hilton East Madison ← Click here to book today!

4402 E Washington Ave

Madison, WI 53704

(608) 244-4703

Alliant Power Code: 3201912
Regarding flights:

We recommend that students arrive the afternoon before the class start date. For those flying into Madison, WI, we recommend booking flights to Dane County Regional Airport (MSN), which is approximately a 12-minute drive to the Alliant Power Windsor, WI facility and about 10 minutes from the hotel.

If you are departing from Denver, CO on the last day of class, we recommend scheduling your departure after 6:00 PM, if possible. Denver International Airport (DEN) is roughly 40 minutes from the hotel and 35 minutes from our office, depending on traffic. If you plan to rent a car, please allow an additional 20 minutes for the return process.

Terms and Conditions
Date

MonthDayYear
Date
Signature

Powered by Jotform SignClear
Please verify that you are human*
Should be Empty: