954.979.4740
 

Workshop Registration Form

Fields marked with an (*) are required.
Were you invited to a private workshop?
Enter your invitation code:
 

1. Select the workshop(s) you want to attend: *


   
Fine Arts Workshop! (2 CE units)
Friday, February 24, 2017 | 11:15 AM - 1:45 PM
Cabinets Workshop! (3 CE units)
Friday, February 24, 2017 | 2:00 - 5:00 PM
 

2. License Information


Enter your adjustor's license number and state.

License No.: *
State: *

Registered for workshops before?
After entering your license number and selecting a state, click on "Check License..." to prefill the contact and business information sections below.



3. Contact Information


First Name: * Last Name: *
Address 1: *
Address 2:
City: *
State: *
Zip:
Cell Phone:
Alternate Phone:
Email:
The above email will receive a confirmation email.

4. Business Information

Use Contact Address

Company Name: *
Address 1: *
Address 2:
City: *
State: *
Zip: *
Phone: *
Fax:
Email:



5. Payment Information


You must bring your Adjustor's license to the course to receive credit. If you are paying by cash or check, payment must be received 10 days prior to the event or you registration will be voided.

Payment By/Type: *
Amount: *  (Enter proper amount from flyer.)



Yes, send me an email confirmation for this workshop registration.