Service First Education and Training                       
                  Office: 1-800-729-1949    Fax: 704-596-4490   
                                Email: sftng@aol.com    

            Workshop Titles, Locations, Dates And Fees:
             Click Here to Select the Workshop You Plan to Attend NORTH CAROLINA (5 Contact Hours) Effective Listening Skills - Charlotte, NC - 6/18/11 - $32.00 Per Person Effective Listening Skills - Greensboro, NC - 6/25/11 - $32.00 Per Person Challenging Behavior - Charlotte, NC - 7/23/11 - $32.00 Per Person Challenging Behavior - Greensboro, NC - 8/6/11 - $32.00 Per Person Communicating with Parents - Raleigh, NC - 8/13/11 - $32.00 Per Person Communicating with Parents - Charlotte, NC - 9/10/11 - $32.00 Per Person Communicating with Parents - Greensboro, NC - 9/17/11 - $32.00 Per Person Music and Movement - Raleigh, NC - 10/1/11 - $32.00 Per Person Music and Movement - Charlotte, NC - 11/12/11 - $32.00 Per Person Classroom Behavior - Raleigh, NC - 12/3/11 - $32.00 Per Person ********************************************* SOUTH CAROLINA (5 Contact Hours) Communicating with Parents - Greenville, SC - 8/20/11 - $32.00 Per Person Supervising People - Columbia, SC - 8/26/11 - $37.00 Per Person Communicating with Parents - Columbia, SC - 8/27/11 - $32.00 Per Person Music and Movement - Columbia, SC - 10/8/11 - $32.00 Per Person Supervising People - Greenville, SC - 10/14/11 - $37.00 Per Person Music and Movement - Greenville, SC - 10/15/11 - $32.00 Per Person ******************************************* TENNESSEE (6 Contact Hours) Supervising People - Knoxville, TN - 9/23/11 - $41.00 Per Person Communicating with Parents - Knoxville, TN - 9/24/11 - $36.00 Per Person Supervising People - Nashville, TN - 10/21/11 - $41.00 Per Person Music and Movement - Nashville, TN - 10/22/11 - $36.00 Per Person Communicating with Parents - Knoxville, TN - 11/5/11 - $36.00 Per Person ****************************************** ALABAMA (6 Contact Hours) ************************************************* VIRGINIA - (5 CONTACT HOURS) ***************************************** ILLINOIS (6 CONTACT HOURS) **************************************** MISSISSIPPI (6 CONTACT HOURS) **************************************** OHIO (6 CONTACT HOURS) ****************************************** KENTUCKY (6 CONTACT HOURS)

            Name(s) of Participant(s):
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                 Select Your State          North Carolina South Carolina Tennessee Alabama Georgia Virginia Kentucky Arkansas Mississippi Ohio                                                  Zip Code      

                 Telephone #                                                            Fax #      

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                 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 registration and receive email confirmation.

                 Select Credit Card    MasterCard Visa Amex Discover          

                 Amount                     $

                 Card Number              ---

                 Expiration Month        January February March April May June July August September October November December         Expiration Year     2011 2012 2013 2014 2015 2016 2017           3 Digit Card Code   

                 Card Billing Street Address   

                 Card Billing Zip Code              

                 Card Holder's Name    
         
                                                            

                 Please Note:
                1. Review the information you entered on the form before you click the submit button.
                2. Click the submit button only once.
                3. After you click 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.
                4. After your credit card is processed, an official confirmation along with a copy of your credit
                     card receipt will be sent to the email address entered on your form within 24 hours. 
                 
                     Thank you, and we appreciate your business.
    .                Service First Online Registration Team