Name Address
Town State and Zip
Your Email Phone
Email Phone
15hrs @ $150.00 for live and/or HS Yes or NO
12Hrs @$125.00 for live and/or HS Yes or NO
9Hrs @ $102.00 for live and/or HS Yes or NO
6Hrs @ $73.00 for live and/or HS Yes or NO
3Hrs @ $39.00 for live and/or HS Yes or NO
Or downloadable CORE ONLY
Please note a $9.00 charge will be added for S&H if booklets are to be mailed
Live_HS_Combination
ex: Concord 0/00/0000- 9hrs w/ 1 Ethics HS book
ex: Manchester 0/0/0000 6hrs concord 0/00/0000 9hrs live
ex: Core, ethics and fair housing HS booklets
Please tell us courses you would like to take here
If Bringing or mailing a check please note check number here, If paying by CC please fill in the form below
Credit Card Number: note: 16 digit cc number
Exp Date: expiration date
Sec. Number: Cards Security number
Billing Zip Code for Card Billing zip code for CC being used
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