Test Seminar

DATE & TIME

10/07/2023
8:00 am - 5:00 pm

Local time based on seminar location.

REGISTRATION

Seminar Registration

Ticket Type	Price	Spaces
Advanced	$275.00
First Name * Last Name * Email *
Additional Attendees	$150.00
First Name * Last Name * Email *
Additional Attendees +CEU	$245.00
First Name * Last Name * Email *
Student	$99.00
First Name * Last Name * Email *

Registration Information

First Name *

Last Name *

Active DC License Number *

Email *

Address *

City *

State/County *

Zip/Post Code *

Country *

Office Phone

Cell Phone *

How did you hear about us?

Credit Card Type *

Credit Card Last 4 digits *

Coupon Code Acknowledgment * I acknowledge and understand that if I have a coupon code, I must enter it at time of registration. I understand that a discount cannot be applied after my registration is completed

Payment and Confirmation

Coupon Code

I consent to my submitted data being collected and stored as outlined by the site Privacy Policy.

Credit Card Number

Expiry Date /

CCV

100% refund 30 days before the seminar start date. Credit only after 30 days of the seminar start date.

I acknowledge and understand that if I have a coupon code, I must enter it at time of registration. I understand that a discount cannot be applied after my registration is completed.

Payment Processing

Test Seminar

Published by digital on 10/07/202310/07/2023

Test Seminar

REGISTRATION

Seminar Registration

Registration Information

Payment and Confirmation