Certified Trainer Program

Your Name
Address:
Street 1
Street 2
City
State
Zip
Country
Organization/Affiliation
Position
Daytime Phone
Other Phone
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.

Credit Card
(please contact Dawn Senfeld at (678)839-5489 to process card.)

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
  Honors House
  Carrollton, Georgia 30118

Or Call: 678.839.6248 for Help.