Master Presenter Class Online Registration CC

Name *

First

Last

Organization

Rank or Position

Email *

Textable Phone *

Please upload list of registrants

Click or drag a file to this area to upload.

You may send either a word file or use our pdf file under "check request form" To secure each spot, each registration requires a name, rank, testable phone and email address.

Payment Information

Billing Contact *

First

Last

Billing Contact Phone *

Billing contact email *

Selection Location *

Select Number of Registrations Purchased *

The class fee is $995. If you prefer to avoid this cost, please download and use the pdf registration form for the class and email Kelle Corvin at kcorvin@lhln.org and she will be happy to issue you an invoice to pay by check. We understand that schedules change and you may not be able to attend. If this happens, we will work with you to find another class location that suits your schedule. In the event that a refund is issued, a $200.00 fee per registration will be withheld.

Credit Card *

Card Number

Security Code

Name on Card

Expiration/

Email to send receipt of payment *

Phone of Cardholder *

Billing Address of Cardholder *

Address Line 1

Address Line 2

City

State

Zip Code

Special Instructions

This field is provided so to let the host agency and CCG know if a student attending will need any special assistance, such as "on crutches" or "needs wheelchair access" or need a seat close to the front for hearing/seeing issues or other related issues..