Webinars are available for a month following approved access. Please fill out this form and e-mail to firstname.lastname@example.org or mail to the address at the bottom of this form.
Organization Name: _______________________________________________________
Attendee name: __________________________________________________________
Attendee e-mail: _________________________________________________________
Attendee phone: _____________________ Organization phone: ___________________
Are you interested in receiving C.E.U.s for these webinars? (Must complete all 8 webinars and complete exam) ______________
Each Webinar series will be available to purchaser for one month's time. Would you like to begin this series as soon as possible or on a particular month? (Please provide requested month/year) ____________________
Please complete this registration form and e-mail it to:
We will send an invoice for direct credit card and EBT payments within 5 working days of receiving your e-mailed registration form.
Cost is $95.00 per person
Please check applicable boxes:
Payment method: o Credit Card o EBT o I have included/or will send a check
oPurchase Order # ___________________________Contact Name___________________________
Cancellation Policy: There is no cancellation after payment is made.
Mail Checks and Completed Registration Form to:
P.O. Box 66056
Albuquerque, NM 87193