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AGC New Mexico Building Branch
On-Line Registration Form

You must include your e-mail account and telephone number!

If you wish to pay for the class with a credit card, we will call you back to get that information.   Filling out this form does not register you for class!  Payment must be received prior to actually being registered for class.


Term: Year:

Your Name:

Address where textbook will be sent - 
Number & Street: 
City: State:
Zip Code:  

Telephone Numbers (with area code):
Daytime:           Evenings:
You must include your telephone number(s).

Email Address: (You must include your email address)

Sex: Male Female

List online courses for which you are registering:

Course #1 Title:

Course #2 Title:

Course #3 Title:

Course #4 Title:

Course #5 Title:

Payment Method:
Will send check (must be received by AGCNM within 5 days)
Charging to credit card (we will call you for your card number or call us at (505) 842-1462
Other

Do you have any questions or other comments?


If sending a check, please make it out to New Mexico Building Branch, AGC.   Write the  course(s) for which you are registering on the check. Send your check to the following address.

New Mexico Building Branch, AGC
Att:  Margo Maher
1615 University Blvd., NE 
Albuquerque, NM 87102-1791
(505) 842-1462
Fax (505) 842-1980

Please mail me a confirmation of receipt of registration Yes No

Click here to submit your registration:

 

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