PERSONAL DETAILS STUDENT

Salutation Choose one Mr Mrs/Ms

First name

Last name

Official name

Email address

Phone number

Alumnus UvA

Yes

No

If yes, Programme and graduation year

Name company / employer

Job title

PE credit

Yes

LinkedIn profile

LEAN SIX SIGMA QUALIFICATION

Black Belt level completed at

Year of completion

ADDRESS AND INVOICE DETAILS

Invoice

I will pay the tuition fee myself.

My employer will pay the tuition fee.

I will pay for the invoice myself:

Street and house number

Zip code

City

Email address for invoice

COMPANY DETAILS FOR INVOICING

Company name

Reference number

Address

Zip code

City

Email address for invoice

SIGNATURE

Enrollment Conditions

Please complete this form to register for an ABS Open Programme. By clicking on Submit you accept the following conditions: The participant can only be enrolled when the admission requirements as published on the website are met. The tuition fee for Lean Six Sigma Master Black Belt is €4,650 per participant. The student is at all times personally responsible for the payment of the course fee. To cancel participation, notice of cancellation must be given by email up to 28 days before the course starts. € 250 administration fee will have to be paid. After this date, there will be no refund. If not enough applicants have enrolled for the course, the Amsterdam Business School may decide to postpone or cancel a course up to 14 days before the course starts. In case of cancellation by the organiser, the participants will receive a full refund. The organiser can change the lecturer without giving notice.