EmailMe Form - POS Registration

INDIVIDUAL AND GROUP REGISTRATION

Please use this form to register for the Professional Orientation School for New Forensic Scientists. You may register yourself, a single participant, or a group of participants.

Participant Info: *

I am registering myself only

I am registering myself and others

I am registering others, but not myself

Total number of registrants (including me): *

If you are using this form to register multiple participants OR a participant other than yourself, please provide the names and email addresses of ALL participant(s) you are registering, including yourself:

Your Name:

First Last

Title or Position: *

Email: *

Confirm Email:

Primary Contact Phone: *

### - ### - ####

Alternate Phone:

### - ### - ####

Laboratory/Agency Name: *

Laboratory Mailing Address: *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Registration Option: *

Specific payment instructions will be provided to you by email when you submit this form.

Subscription Code (if applicable)

Subscription codes are for laboratories wishing to purchase seats for multiple participants over the course of one year. If you are deducting this registration from an existing subscription, please enter the code that was provided to your laboratory.

Amount Due:

$ Dollars

Registration is $550 per person.

Please enter the total amount due for this registration.

After submitting this form, you will be directed to our main class page. Please follow the instructions for OPTION 2. You will also receive an email with additional instructions *

I acknowledge