Distance Education Certified Trainer Program Distance Education Certified Trainer Program

If you need to pay via Credit Card, please skip this form and Click Here to Register.

Your Name
Address:  
 Street 1
 Street 2
 City
 State
 Zip
 Country
Organization/Affiliation
 Position
Daytime Phone
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Fax (optional)
Email
Distance Learning Experience
(please list)




$695 (includes course materials, access to online classroom and certificate upon graduation).





Purchase Order
If Purchase Order, please supply PO#

Fax Purchase Order to: (678)839-0636, attn: Dawn Senfeld. Must be received within 24 hours of registration.




I will mail a check (drawn on US funds). Please make payable to:
University of West Georgia.

Mail to:
  University of West Georgia,
  attn: Dawn Senfeld
  Distance & Distributed Education
  Murphy Building
  Carrollton, Georgia 30118

Or Call: 678.839.6248 for Help.