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Class Registration Form
Order Confirmation #
First name
Last name
Company
Email
Phone
Job Title
Birthdate
*
required
Any dietary restrictions?
What is your Level of Experience in the program you enrolled in?
*
Required
Beginner
1-2 years
3+ years
Current Industry?
*
Required
Auto Glass
ADAS / Calibration
Body / Collision
Detailing
Entrepreneur
PDR / Hail
Other
Tinting
Windshield Repair
Let us know what you hope to learn in this class?
ADAS Class
ADAS class only (select all that apply)
*
Required
did not enroll in ADAS class
I own a system already.
Trying to decide which system to purchase.
Dynamic focused
Static focused
I want to know it all!
Flat Glass Class
Flat Glass 101 only class (select all that apply)
*
Required
did not enroll in Flat Glass
Residential windows is a priority to learn.
Frameless Showers is a priority to learn.
Commercial Storefront is a priority to learn.
Glass ordering & resources is a priority to learn.
I have cut glass before.
Student is authorized to make purchases for the company?
*
Yes
No
I hereby give Kaizen Glass Solutions permission to use images or videos from my class in its publications, including online publications, without payment or other compensation.
*
Yes
No
How did you hear about us?
*
Required
Past Student Referral
Social Media
Advertisment
Search Engine
I am a KGS Alumni
Tradeshow
Other
I have read and understand Kaizen Glass Solutions Cancellation Policy
View policy
Student Name as you want it to appear on certificate
Form completed by;
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