Class Registration

URL

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

Company(Required)

Are you an AE Member?(Required)

Yes

Address(Required)

Street Address City State ZIP Code

Phone(Required)

Purchase Order # (If required)

Class Name(Required)

Class Date

Registration Choice

Single Registration - $25/per person

Table of 8 - $175/table

Webinar Information

If all participants will be viewing this webinar from the same location, only 1 participant name needs to be provided. If this will be viewed from multiple locations, or more than 1 person wants to receive CEUs, please provide an email and participant name for each additional location/CEU applicant.

Participant Name(Required)

Email(Required)

Are you registering another participant?(Required)

Yes

2nd Participant Name

2nd Participant Email

Are you registering a 3rd participant?

Yes

3rd Participant Name

3rd Participant Email

*NOTE: If registering more than 3 participants, please contact our office directly at 406-248-6178.

Additional Participants

Additional Webinar Participants (Alternate Location)

Must include email address

Live Webinar Purchase

Price:

2nd Participant

Price:

3rd Participant

Price:

Payment Method(Required)

American Express

Discover

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name

Total

Comments

Cancellation Policy:

If you must cancel, please do so at least 2 business days prior to the start of training. Any cancellations received with less than 2 business days’ notice, will be billed as follows: $30 for our Reasonable Suspicion class, $50 for any half-day class, $75 for any full-day class or $100 for the Management Excellence Series. Please call our office at 406.248.6178 or email reg@aehr.org to cancel. Substitutions are welcomed with prior notice.