The Helms Group - Education & Training Enrollment Form

Company Information

**Please note this is not a secure form - it may be printed, filled out and faxed to us at 310 769 6138

Date(MM/DD/YY) Code

Company Name

Company AddressSuite

City StateZip

Student Information

Student Last Name

Student First Name

Title SSN or DL (optional)**

Phone Fax E-mail

Department Mail StopCharge # Supervisor
Supervisor Initials

Please tell us about which Classes you are interested in...

 Class# Class Code Class Description Start Date End Date Fee

You will receive a confirmation notice regarding each class. Once your class is confirmed you must notify The Helms Group of any cancellations or rescheduling more than FIVE (5) working days prior to the class start date.