04 - APRIL 2025 CE ZOOM ENROLLMENT FORM

ZOOM CLASS ENROLLMENT FORM for Continuing Education

NOTE: If you need to utilize more than one class date, please call our office at (801) 782-5510 to enroll.

*Required Feild

Attendee's Name (as known by the Ins. Dept.)*

First NameLast Name

Insurance License Number*

Physical Address*

Street Address

Street Address Line 2

CityState

Zip Code

Contact Number*

Format: (000) 000-0000.

Comments/Instructions

E-mail*

ZOOM C.E. Class Schedule

JUNE 10, 2025 (Tuesday)

Zoom class starts at 8:00am

Adapting To Our Customer's Needs 4 credits

LTC, Medicare and related insurance 4 credits

Ethical Behavior and Ethics in Action 4 credits

Enrollment in 24 Credit Hours includes the above 12 hours of class plus 12 hrs homestudy course.

Enrollment Options - JUNE 2025 (choose only one)*

24 Credit Hrs (Insurance and/or Funeral Director)$135.00

LICENSE(S) TYPE OPTIONS
Item subtotal:$0.00

12 Credit Hrs (Insurance and/or Funeral Director)$115.00

LICENSE(S) TYPE OPTIONS
Item subtotal:$0.00

8 Credit Hours (Ins License ONLY)$89.00

CLASS OPTIONS
Item subtotal:$0.00

4 Credit Hours (Ins License ONLY)$49.00

CLASS OPTIONS
Item subtotal:$0.00

Subtotal $0.00Shipping $0.00Total $0.00