Online Course Registration Request
CLASS LOCATION: REMOTE (Your Office or Home)
Client Information
(If multiple students, individual names can be provided later)
Name
*
First Name
Last Name
Email Address
*
example@example.com
Mobile Phone Number
*
Work Phone Number
Name of Company (If Applicable)
Address
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
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District of Columbia
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New York
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Ohio
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Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
# Years of Experience Using Software
*
Current Position
*
What are your top 3 expectations in completing this course? (300 words or less)
*
Course Selection
Available Classes (All classes are from 9 AM - 3PM CST)
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( X )
Excel Level 1
Please select a date.
$
200.00
Class Dates
# of Learners
Jun. 9
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Jun. 12
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Excel Level 2
Please select a date.
$
275.00
Class Dates
# of Learners
Jun. 11
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Jun. 17
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Excel Level 3
Please select a date.
$
350.00
Class Dates
# of Learners
Jun. 18
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Jun. 25
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Acknowledgement and Payment Information
Student Signature
*
Payment Methods
Debit or Credit Card
Choose from one of the PayPal options to
make your payment.
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