REGISTRATION FORM

FILL OUT ONE SHEET FOR EACH REGISTRANT

614 Kennedy St., Anoka, MN 55303
763-421-4163
ctthibodeau@ctthibodeau.net

DIRECTIONS:
1. After filling out this form email to ctthibodeau@ctthibodeau.net or fax to 763-421-4164
2. How would you like to pay for your training? We accept check or credit card.
3. If you wish to pay by check, mail the check or money order to above address.
4. If you wish to pay by credit card please call 763-421-4163
5. $95 for 6-Hours of Online Continuing Training