Information:

Please complete the following information. Fields marked with a red asterisk are required for processing.
 
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* Program Location (city)

 
* Program Date (mm/yy)

 
  Personal information:

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Designations
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  Payment

Workshop registration fees may be paid by mail, or by secure online credit card payment. Please choose an option below.
   
  Cost

$795   Non-member

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Mail Payment - A receipt will be generated that you can print for your records.
  Online Payment - A receipt will be generated that you can print for your records.
   
  Questions? Please contact SITE at (623) 547-6401 or by fax (623) 547-6814 or
e-mail: ed@insurancetrainers.org