BuildATECH™ Registration

Company Information

*Company Name:      Dealer Account #:

*Address:      *City:     State:     Zip:

*Contact Name:     *Phone #:     Fax #:

*E-mail Address:

* Indicates REQUIRED field.

Student Information

Student #1:

First Name:     Last Name:

E-mail Address:

Class: SELECT CLASS Feb 20 - March 16 April 2 - April 27 May 29 - June 22 July 9 - Aug 3 Sep 4 - Sep 28 Oct 8 - Nov 2 Nov 26 - Dec 21

Are you a registered user of our LMS? Yes No

Student #2:

First Name:     Last Name:

E-mail Address:

Class: SELECT CLASS Feb 20 - March 16 April 2 - April 27 May 29 - June 22 July 9 - Aug 3 Sep 4 - Sep 28 Oct 8 - Nov 2 Nov 26 - Dec 21

Are you a registered user of our LMS? Yes No

Student #3:

First Name:     Last Name:

E-mail Address:

Class: SELECT CLASS Feb 20 - March 16 April 2 - April 27 May 29 - June 22 July 9 - Aug 3 Sep 4 - Sep 28 Oct 8 - Nov 2 Nov 26 - Dec 21

Are you a registered user of our LMS? Yes No

Student #4:

First Name:     Last Name:

E-mail Address:

Class: SELECT CLASS Feb 20 - March 16 April 2 - April 27 May 29 - June 22 July 9 - Aug 3 Sep 4 - Sep 28 Oct 8 - Nov 2 Nov 26 - Dec 21

Are you a registered user of our LMS? Yes No

Method of Payment

Bill My Lennox Dealer Account   Credit Card   For credit card payment call 800.654.3283, Option 2

Dealer Acct#:    Check here if you are a Premier Dealer.

Please enter the code below.

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