Registration Form

There is no charge for the 14 hour in class continuing education course. All expenses are paid for by our generous sponsors. A $25.00 registration fee will be charged and refundable upon attendance at the class. Failure to attend will result in forfeiture of the deposit. Space is limited and is based on first come first served protocol.

Name *
E-mail Address *
Address *
Type of License
License Number *
	Text book $15.00 (optional)
	Registration $25.00 (refundable upon attendance)
Payment method	Master Card Visa Discover
Card Number
Expiration date

* Fields marked with an asterisk are required fields

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This is a sponsored event and the generous sponsor would value your patronage. By registering for this event you authorize one email per month from the School and each of the sponsoring companies to be sent to your email address. Your email address will remain in confidence with Avey School and will not be distributed to any other parties.