CPE Registration

First Name(Required)

Last Name(Required)

Suffix

Jr., Sr., etc

Phone(Required)

Email(Required)

Company Name

Type ”Individual” if not affiliated with any agency or firm.

Company Division

Address(Required)

Street Address Address Line 2 City State ZIP Code

Please Select a CPE Seminar:(Required)

Date of CPE(Required)

CPE Type(Required)

The cost for Virtual CPE seminars is $130 per person. The cost for In-Person CPE seminars is $175 per person.

Number of Participants(Required)

Please enter a number from 1 to 100.

Enter the number of individuals who will attend on the date noted above.

Entity Name(Required)

Type ”Individual” if not affiliated with any agency or firm.

NAMES & EMAIL ADDRESSES OF ALL PARTICIPANTS(Required)

Name

A correct name and email address for each participant is required to receive a certificate of course completion.

Transaction ID Number(Required)

Captcha

Name

This field is for validation purposes and should be left unchanged.