Clinic Request Form

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Clinic Request Form

Clinic Request & Confirmation Form

Request for all BAB Steering Clinics must be received THREE months prior to the actual clinic date. All request must be submitted on this clinic request form. Please complete the information requested below and fax to the BAB Sales Department at 208.331.1047 or E-mail to Sales@babsteering.com. You will receive a confirmation number via return fax within 72 hours. If you have questions please contact your BAB sales rep.

Please provide the following information so BAB can supply you with flyers

Enter the distributor name in the space provided below.

Please provide the following contact information:

Street Address

Address (cont.)

City

State/Province

Zip/Postal Code

Country

Work Phone

E-mail

Enter your clinic location in the space provided below (Hotel name & address)

Enter the hotel room in which the clinic will be held in the space provided below.

Enter the date of the clinic: -- mm/dd/yy

Enter the time the clinic will begin: -- hh:mm:ss am/pm

Enter the time the clinic will end: -- hh:mm:ss am/pm

Enter your purchase order number:

Do you want BAB Bucks, if so $ amount:

How many will attend?
(Please estimate, you can verify the count a week prior to the clinic, but we neeed a count in order to provide the correct supplies.)