Course Title and Tuition:
  Click Here to Select Appropriate Course Fee Fundamentals of Child Development - 4 hours - $30.00 Per Person Classroom Behavior Management - 4 hours - $30.00 Per Person

 Course Book Fee Chart:
  Click Here to Select Appropriate Course Book Fee Fundamentals - 1 - 3 Participants - 1 Course Book - $15.00 Fundamentals - 4 - 6 Participants - 2 Course Books - $30.00 Fundamentals - 7 - 9 Participants - 3 Course Books - $45.00 Fundamentals - 10 - 12 Participants - 4 Course Books - $60.00 Fundamentals - 13 - 15 Participants - 5 Course Books - $75.00 Classroom Behavior - 1 - 3 Participants - 1 Course Book - $15.00 Classroom Behavior - 4 - 6 Participants - 2 Course Books - $30.00 Classroom Behavior - 7 - 9 Particiapnts - 3 Course Books - $45.00 Classroom Behavior - 10 - 12 Participants - 4 Course Books - $60.00 Classroom Behavior - 13 - 15 Participants - 5 Course Books - $75.00

 Name(s) of Participant(s):

   1.          2.        3.

   4.          5.        6.  

   7.          8.        9.

  10.       11.     12.  
 
  13.       14.     15.   

 Child Care Center /      
 School / Organization       


 Mailing Address                 

 City, State, Zip Code          

 Telephone #                          

 Fax #                                      

 Email Address                     

 Email Contact Person            

  Please Note: Credit Card Number, 3 Digit Card Code, Expiration Date,
  Card Holder's Address, Card Holder's Zip Code, and Card Holder's Name
  must be submitted in order to complete course enrollment and receive 
  email confirmation.

 Select Credit Card           Visa MasterCard Amex Discover          

 Total Amount                          $

 Card Number                  ---

 Expiration Month             January February March April May June July August September October November December         Expiration Year     2008 2009 2010 2011 2012 2013

  3 Digit Card Code                    

  Card Billing Street Address   

  Card Billing Zip Code           

 Card Holder's Name    

                                                                 

 Please Note: After you click on the submit button, a "Form Confirmation" page showing the
 information that you entered will appear. Please review the information and print a copy for
 your records. This is not an official confirmation.

 After your credit card is processed, an official course enrollment confirmation will be
emailed to the address  entered on your form.  Thank you, and we appreciate your business.

 Service First Online Registration Team