Stata Short Course Licenses

Please note:

Requests for course licenses should be submitted no more than approximately two weeks before the course is scheduled to begin.
Name *
Surname *
Email address *
Type of customer *
Name of course *
Location of course
Course instructor name (if different than contact)
Dates of course *
Number of attendees *
Type of license *
Will the course be leading to academic credit recognition towards a degree? *