ONE-DAY LIVE EXAM PREP COURSE

BUY NOW -- SCHEDULE LATER

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PLEASE REMEMBER:  You must schedule and attend a Live Exam Prep class by Wednesday, April 25, 2018.

Should you have any questions, please contact our office at 800 - 439 - 4909.

Office hours are 9 am and 4:45pm, Monday through Friday, excluding holidays.

REGISTRATION

Please provide us with the following registration information.   All fields are required.


BILLING INFORMATION
First Name:
Last Name:
Address:
City:
State:
Zip Code:
Daytime Phone:
( ) -  
e-Mail:


SHIPPING INFORMATION

Same Address as the Billing Address

 

Please provide a shipping address where someone will be available to accept the materials.
Please, no PO Boxes.

Company Name (Opt.):
First Name:
Last Name:
Address:
City:
State:
Zip Code:


HOW DID YOU HEAR OR LEARN ABOUT US?
 


PAYMENT METHOD

We gladly accept Visa Card, American Express, MasterCard, Discover Card

An amount of $150.00, payable to Duane Gomer, Inc. will charged on the credit card that you provide below.

Credit Card Number:
Expiration Date:
 / 
Card Verification Code:
 Location of Card Verification Code 
Amex
Visa / MC / Discover