Personal Informaton

Contact Information

Mailing Adress

Billing Address (if different from above)

Please indicate which course modules you will attend:

* If you choose to pay with a credit card or P-card, you will be taken to our PayPal payment page when you submit your registration. Once there, click on "Don't have a PayPal account?" or "Pay with a debit or credit card or Bill Me Later," (depending on whether or not PayPal recognizes your email) which will be half way down the page on the right. You will then be prompted to enter credit card or P-card information. You do NOT have to have a PayPal account for this payment. If you prefer to be invoiced, you can skip the following payment step and we will mail you an invoice.