HERS rater training class registration

• Please complete the online registration below.
• After submitting your registration, if paying online, you will be taken to the payment page.
• Payments can be made by either by credit card or check.
  • Credit card payment by Visa, M/C or Discover online.
  • Check payments, please mail to the mailing address at the right. Please complete registration below.
• For security, we use webconnex to process your online payment. The information entered below is required for our student records and is not related or transferred to the online payment system.
• All Required items must be completed and are indicated by an *.

First Name:	*
Last Name:	*
Company:
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Address2:
City:	*
State:	AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA PR RI SC SD TN TX UT VT VI VA WA WV WI WY *
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Comment:
Have a Laptop:	YesNo*
Select a date for Module 1 - Rater class
-Select Class- July 7-12, 2014 *
Select a date for Module 2 - CAZ class
-Select Class- June 23-25, 2014 July 21-23, 2014 Aug 6-8, 2014 Sept 15-17, 2014 *
Payment type:	Mail a Check Online with CC *
Please only click once, may take a minute to process.

Class information

2 weeks
8:30am - 5pm

Location*
Our Office
21750 Red Rum Dr
Suite 117
Ashburn, VA 20147
703-797-2051
*Unless otherwise noted

Mailing address

MABTEC
Attn: Class Registration
PO Box 223959
Chantilly, VA 20153