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Training Class Payment Form (Terminal)
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This form has been modified since it was saved. Please review all fields before submitting.
Instructions
Complete the form below to process payment for classes at the Ben Clark Training Center. Please remember to enter your confirmation INVOICE NUMBER. Only one transaction per student will be accepted.
Course Title
*
Class Date
*
Agency
*
Course Cost
One Student Per Transaction
Price Per Student
*
Quantity
Shipping Cost
Taxable
Student’s Name
*
INVOICE NUMBER
*
Training Coordinator / Liaison
*
Training Coordinator / Liaison Email Address
*
Leave This Blank:
Calculate Totals
Proceed to Checkout
* indicates a required field
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