(Please fill out all sections to register)
*Full Name (First, Last)
*File No.
*Full Address
*Home Phone *Business Phone
*Email
*Broker (Company Name)
*Broker Address
Check all boxes for the whole month if enrolling in the complete program. Which is 4 days - 30 hours for $175.00 OR Take only the course offerings you need by checking the appropriate course title and date.
Once this form is submitted you will receive an email confirming receipt of your registration. You will be responsible for totalling the amount of your payment which will be due upon arrival to your first class. Class names, prices, and hours are also listed on the classes page.