Preregistration Thank you for your interest in attending one of our onsite training courses. Please complete this brief customer qualification review form.If you are already registered, please login below to complete Preregistration, or Logged in Users Click Here Already Registred on NKU?Username(Required)Password(Required) Remember Me Forgot Password PhoneThis field is for validation purposes and should be left unchanged.Name* First Last Title*Facility*Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email* Phone*Password* Enter Password Confirm Password Strength indicator This field is hidden when viewing the formSelect Desired Course Patient Monitoring Systems Service Seminar EEG Fundamentals & cEEG in the Critical Care EEG, PSG, EMG, IOM Service Seminar Advanced Polysmith Training NKV-550 Service Seminar NKV-440 Service Seminar NKV-330 Service Seminar Repair Training This field is hidden when viewing the formSelect which products your facility utilizes EEG PSG EMG IOM This field is hidden when viewing the formDesired course datePlease select the option below that best describes how your tuition will be covered. Supporting documentation may be requested to validate your selection.Tuition Fee Options* I will submit payment via Purchase Order I will pay by Credit Card I have a tuition code that will be used My tuition may be waived based on my facility’s purchasing agreement My tuition may be covered under an active service contract My tuition may be waived under an active device warranty I am unsure of my waiver eligibility and would like to request a review This field is hidden when viewing the formDo you qualify to attend this training for free? Yes, my facility pre-purchased training. Yes, my facility’s equipment is under warranty. No, I will pay with a credit card or purchase order. I don’t know. Please check for me. Purchase Order*Max. file size: 512 MB. Device Serial NumberEnter the serial number of the Nihon Kohden device under warrantyAdditional InformationPlease provide any additional information that may help determine eligibilityCancellation Policy Consent* I agree to the Booking policy.CancellationNO-SHOW POLICY: Nihon Kohden LLC no-show policy stipulates that the full tuition fee will be charged if a participant fails to attend a scheduled class without providing a written minimum 10 days' notice. Should a tuition waiver have been used during registration, the full tuition fee will be applied, or the waiver will be forfeited. This policy is in place to acknowledge the resources and preparation invested in the arrangement. Your understanding and cooperation in adhering to this policy are greatly appreciated. CLASS CANCELLATION: Nihon Kohden America, LLC retains the authority to cancel any seminar or class at its discretion. In the event of cancellation, registered attendees will receive timely notification, and their tuition will either be refunded or applied towards a future seminar or class.Privacy Policy Consent* I agree to the privacy policy.CAPTCHA