Orbit Educational Group


Questionnaire

1-800-372-5211

Technology is the Future!

 

Name:
Mr. Ms.      First   Middle Initial   Last

Home Address:
      

City   State

Country     Zip/Postal Code 

Telephone #     Secondary Telephone # (optional) 

E-Mail Address  

Are you colorblind?
   No Yes

Can you lift 40 pounds?
   Yes No

Where did you first hear about Orbit?
   TV Newspaper Radio Friend Relative Job Fair High School Not Sure

Company Name (if applicable)N/A

Company Phone (if applicable)N/A

Which program are you most interested? (select one)
Not all Programs are available at all sites


Orbit Educational Group, Inc.
is an Equal Opportunity Training Institution

For program questions or alternate delivery of programs contact info@wrightco.com
Mailing Address: 13547 Dunnings Highway, Claysburg, PA 16625

Copyright 2009 Orbit Educational Group, Inc.