MyEPAclass Registration

Class Registration

Section A. Student Information
How many Students are you registering? Select up to 5:

* (An entry is required in each space. If an item is "Not Applicable" type: N/A)

IMPORTANT! Please enter Student information exactly
as it should appear on Student's EPA Certification. 1. Student One
*1a. Name:
*1b. Email: (e.g.: name@aol.com)
*1c. Company/Agency Name:
*1d. Address (Home or Office):
*1e. City:
*1f. State:
*1g. Zip:
*1h. Phone #: (include AC)
*1i. Birth Date (mm/dd/yyyy)

2. Student Two
2a. Name:
2b. Email: (e.g.: name@aol.com)
2c. Company/Agency Name:
2d. Address (Home or Office):
2e. City:
2f. State:
2g. Zip:
2h. Phone #: (include AC)
2i. Birth Date (mm/dd/yyyy)

3. Student Three
3a. Name:
3b. Email: (e.g.: name@aol.com)
3c. Company/Agency Name:
3d. Address (Home or Office):
3e. City:
3f. State:
3g. Zip:
3h. Phone #: (include AC)
3i. Birth Date (mm/dd/yyyy)

4. Student Four
4a. Name:
4b. Email: (e.g.: name@aol.com)
4c. Company/Agency Name:
4d. Address (Home or Office):
4e. City:
4f. State:
4g. Zip:
4h. Phone #: (include AC)
4i. Birth Date (mm/dd/yyyy)

Did you enter Student information exactly as it should be
printed on Student's EPA Certification? If not, please do so now.
Section B. Class Information

*1. Select class:

2. Enter Group Discount Code (if applicable) << Use all CAPS

*3. Enter Verification Code:

<< Verification Code

4. Payment is required. Your registration is not complete until payment has been received. You can pay by Credit Card on the next page. If you wish to pay by a method other than a Credit Card, complete this registration and then please call (800) 648-5323.

When you are ready to proceed, hit [REGISTER] once. Thanks!