Instructor Facilitated Online Course Registration Form

Course Title*
Name*
FirstLast
Last Four Digits of SS Number
Employer Name*
Employer Address Information*
Street AddressAddress Line 2CityStateZip Code
Work Phone Number*
Ext.
Work Fax
Email*
Home Address Information
Street AddressAddress Line 2CityStateZip Code
Payment Method*
- Bill My Employer
- Credit Card
If you have chosen "Bill My Employer", authorization and payment arrangements with your employer will be verified prior to processing your registration form. If you have chosen "Credit Card", CFT Personnel will contact you for credit card information prior to processing the registration form.
Authorized By*
Email*
Phone Number*
Shipping and Correspondence Preference*
- Home
- Business
DISCLOSURE: By submitting this form, I acknowledge that I have read the withdrawal policy and academic integrity statement found on this website and fully understand their meaning. I authorize the Center for Financial Training to release my grades and course profess to the appropriate representative at my company and share educational information with me via e-mail. I understand that if I fail to meet the tuition and fees to my company and/or CFT, as well as any fees associated with the collection of these balances.