Online Registration Form

QFD Green Belt Certificate Course
November 89, 2017 in Michigan

This online form is provided for your convenience; however, it is not secure for credit card protection. If you prefer, please fax or e-mail Word form or PDF form instead.

For questions, please contact QFD Institute, Tel: +1 734-995-0847 or see the Terms & Conditions.

1. Attendee Information

Attendee Name


This name will be printed on your certificate. Please type full name accurately.

Job Title





Complete Address for your Receipt / Invoice


Work Phone




Vegetarian / Special Dietary needs, Barrier-free needs if any


2. Registration Fees

  • US$2,145 per attendee.

  • The fee includes your copy of the QFD Green Belt® training manual, templates, case studies and lunch.

  • $100 per person discount is applicable when three (3) or more people attend from the same company. The discounts will be applied from the 3rd attendee's statement.

  • Notes to QFD Institute (if any)

3. Select Payment Method      Registration Terms & Conditions

Pay by Credit Card  (Visa, MasterCard, Amex, Discover)

By providing the card information, I agree to the charge by the QFD Institute for the amount above.

Card Number

Cardholder's Name

Expiration Date (Month / Year)

CVC Code (see pictures below)


VISA / MC / Discover = The last 3 digits on the BACK 


American Express = 4 digits on the FRONT right

Cardholder's Email (if different from the attendee)

Billing Address of this card (including Postal Code)


Pay by Check  (See the Terms & Conditions)

Pay by Wire Transfer  (See the Terms & Conditions)







Payment by Check: Please make the check  PAYABLE TO: QFD Institute, 1140 Morehead Ct., Ann Arbor, MI 48103.   Checks must be in US$ drawn on a US bank, and arrive at least 2 weeks prior to the start of your course, unless other arrangements are made with the QFD Institute in advance. Registration will be confirmed upon receipt of full payment check.

Payment by Wire Transfer: Wire transfer instructions will be e-mailed to you upon receipt of your registration. The transferred funds must arrive at least 2 weeks before the start of the course. The attendee pays all bank fees associated with wire transfer services; please instruct your purchasing department and bank to add applicable bank fees to your registration fees. Registration will be confirmed upon receipt of full payment.

Cancellations after Registration & Substitutions: Cancellations notified at least 6 weeks prior to the course date will be refunded in full, minus a 10% card processing fee if a credit card was used for payment, or minus the applicable bank fees if transactions were made by wire transfer. (No processing fee if paid by a company check.) No refund will be made for cancellations notified within 6 weeks of the selected course date; however, substitutions are permitted without penalty.

Start and End Time: This 2-day course will be held from 8:00 AM to 4:00 PM on both course days. Please plan on full days on both days and schedule your travel accordingly. Late arrival and early departure could jeopardize your receiving the certificate.

This course requires pre-registration and pre-payment. Registration will be confirmed upon receipt of full payment. No walk-ins will be accepted.

Course Cancellations by the QFD Institute: The QFD Institute will make every effort to keep the scheduled course dates. In the event of course cancellation by the QFD Institute, the QFDI's liability is specifically limited to refunding the applicable course and/or program fees and excludes any incidental or consequential damages.

QFD Institute reserves the right to refuse sales of any product or service to anyone or any organization. Registrations with untrue, inaccurate, or incomplete information may not be processed. Registrations with overseas P.O. box addresses may not be accepted.


Contact QFD Institute