Courses.PriorityDispatch.net - ETC Course Application

Date/Time

MonthDayYear
HourMinutesAM/PM Option
Course Information
ETC Edition*
Course Type*
Advertise on PDC Website?*
Start Date*

MonthDayYear
Start Time*

:HourMinuteAM/PM Option
End Date*

MonthDayYear
End Time*

:HourMinuteAM/PM Option
Instructor's First Name*
Instructor's Last Name*
Instructor's Email*
Host Agency
Host Agency Name*
Host Agency Contact Person*
Host Agency Address*
Host Agency City*
Host Agency State/Province*
Host Agency ZIP/Postal Code*
Host Agency Phone*
Host Agency Email*
Course Location
Course Location same as Host Agency?*
Course Location Name*
Course Location Contact Person*
Course Location Address*
Course Location City*
Course Location State/Province*
Course Location ZIP/Postal Code*
Course Location Phone*
Course Location Email*
Course Manuals
Course Manuals Needed?*
Quantity of Course Manuals*
Course Manual Type*
Select Shipping Address*
Shipping Contact Person*
Shipping Address*
Shipping City*
Shipping State/Province*
Shipping ZIP/Postal Code*
Method of Payment
Method of Payment*
P.O. Number*
Billing Address
Select Billing Address*
Billing Contact Person*
Billing Address*
Billing City*
Billing State/Province*
Billing ZIP/Postal Code*
Terms and Conditions
Course Application Review and Approval Terms*

Yes, I understand that my course application will not be scheduled until it's been reviewed and approved by a Priority Dispatch representative. I will be contacted by a representative within two full business days.
Universal Course Agreement, Terms and Conditions
Universal Q Agreement, Terms and Conditions
Privacy Policy
Terms of Use
Additional Terms*

Yes, I agree to the aforementioned Terms and Conditions, Privacy Policy, and Terms of Use.
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Course Information

Host Agency

Course Location

Course Manuals

Method of Payment

Billing Address

Terms and Conditions