Congratulations on your achievement!
Human Resource Management Certificate of Completion

NAME (as you would like us to print it on your certificate):

ADDRESS (where would you like us to mail your certificate):

Street:
Company:
City:		State:		Zip:

DAYTIME PHONE # (in case we need to contact you):

EMAIL (in case we need to contact you):

Comments or special instructions (Have you changed your name? Do you have a course waiver? other.)