Credit Card Registration Form
Food Safety Manager Class/Exam/Products

Public Agencies - Purchase Orders
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Credit Card Payment Only - Registration Information

Company Name (Use "SELF" if no company.) *

Phone Number (Area Code) + (Phone Number) *

Email (This is where a confirmation will be sent.) PLEASE FORWARD A COPY OF THE CONFIRMATION TO ALL ATTENDING. *

Email - Enter again to confirm *

Business Mailing Address *

City *

State *

Zip Code *

SELECT DATE/LOCATION: (Class start time 9:00 am unless noted.) *

NUMBER OF ATTENDEES - Enter the number 1, 2 or up to 15 for the number of attendees in each box.

Quantity:

Every box requires a number from 0 - 15.

* 🛈

	Food Manager Class and Exam ($169.00)
	Food Manager Exam (No Course) ($109.00)
	Manager "Re-Test" Only (Did not pass previously. Includes class.) ($79.00)

A few days before the class/exam, we will send you a reminder email, and at that time, you will need to respond with the names and email addresses of everyone coming to the class/exam. We will need this information to set up an account for each person to take the exam.

Do you have a coupon or promo code? Coupons are ONLY available for the COURSE AND EXAM, not for exam only or re-test. 🛈

Current Total:

$0.00

Check here to agree to all purchase terms and conditions. * 🛈

Yes

How did you hear about us? *