PSC1 Group Registration Form

PSC Level 1 Group Registration Form
Instructions: A completed group registration form must be submitted in order to process your group registration request. The company representative must complete the form below and provide the first name, last name, and email address of all registrants in the group. Please submit the completed form at least three (3) business days prior to the webinar date to ensure timely registration.
General Information
Name:
Company Name:
Phone Number:
Please enter a valid phone number.
Email:
example@example.com
Please note that each individual registration counts as a seat for one (1) person and not intended to be viewed as a group. PDH credits are only available for registered participants of the live training sessions. For any questions or inquiries, please contact us at 973-267-9700 or through our Customer Support Center.

Once the payment is processed, all group registrants will be manually registered by HI University staff.

Important: Each registrant needs to create a free user account with their company email to ensure their timely registration. Once registered, access to the training will be via the training website at training.pumps.org.
List Of Registrants

Payment Information
Will you be paying by Card or Invoice?

CardInvoice
Invoice
Please fill out this additional information. You will recieve your invoice via the email address provided above within the next 24 hours.
Is your company an HI Member or Partner?

YesNo
If you are unsure, please contact us at training@pumps.org or through our Customer Support Center to ensure your registration is processed swiftly and with the proper discounts.

Bill To Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Total number of registrants:
Total cost:
Is your company an HI Member or Partner? If you are unsure, please contact us at training1@pumps.org or through our Customer Support Center to ensure your registration is processed swiftly and with the proper discounts.

Number Of Registrants	Member Rates (Per Registrant)				Non-Member Rates (Per Registrant)
Number Of Registrants	Bundle A	Bundle B	Bundle C	Bundle D	Bundle A	Bundle B	Bundle C	Bundle D
1-4	$337	$900	$1050	$1200	$450	$1200	$1400	$1600
5-9	$320	$850	$1000	$1150	$433	$1150	$1350	$1550
10-15	$285	$800	$950	$1100	$398	$1100	$1300	$1500
16+	$250	$750	$900	$1050	$363	$1050	$1250	$1450

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PSC Level 1 Group Registration Form