Contact - Form


Executive 2000 Repeat Class Form
Please complete the following form for class repeats. Items in red must be completed.

Repeat Course Name
(up to 3)

1.
2.
3.
Repeat Course Date 1.
2.
3.
Date Course Last Taken 1.
2.
3.
First Name
Last Name
 

E-mail Address

 
Daytime Phone
Fax
 
Preferred method of Contact
 E-Mail    Mail    Fax
 

Comments or Question

 

Registration Agreement
By accepting this agreement, you acknowledge and agree:

  • Registrations are on a first come, first serve basis. Should you be placed in a wait list, you will be notified by Executive 2000 staff of your wait list status.
  • Executive 2000, Inc., reserves the right to postpone review sessions due to low enrollment.
  • Please note that by submitting this registration you agree to notify Executive 2000, Inc of any registration changes 48 hours in advance.
  • Should you register for a review session and fail to appear you will be charged a fee of $50.00. This fee is only applicable if you register for a class and fail to appear. Otherwise there is no charge for a review session.
By submitting this registration I, , hereby agree to all the above conditions. Date -

or

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