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VFPS Advanced Training Registration

Name*

First

Last
Email*
Address 1*
Address 2*
City*
State*
Zip Code*
Phone
Payment Information
Payment Method: Advanced Training Registration Fee $595*
- Pay with Credit Card
- Coupon Code ($0 – Enter Code Below)
- Pay with Check (see information below on where to send payment)
Registration Code
Credit Card

MasterCard

Visa

Card Number

Expiration Date

Security Code

Cardholder Name
Total
$0.00
Paying by Check?
The following information will also appear on a confirmation email you receive after submitting your registration. Please use this email as an invoice and include it with your payment.

If paying by check, send payment to:

Employment Resources, Inc.
2701 International Lane, Suite 210
Madison, WI 53704

Make checks payable to “Employment Resources, Inc.”
Phone

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