REGISTRATION PAGE

LICENSE REVIEW COURSE

FOR THE STATE OF MARYLAND

SPRING 2008

 

Title:
First Name:
Middle Initial:
Last Name:
Home Phone
Work Phone
E-Mail Address
Confirm E-Mail Address
Choose a Login Name
Choose a Password:
Confirm your Password:
Are you a member of MPA?:
Please enter your degree, if any (eg: Ph.D., M.S., None, etc):

Payment Options:

Registration Fees
MPA Members
$ 110.00
Non MPA Members
$ 140.00

1. You must register online using our secure server.

When entering your Credit Card information please include the billing address that matches your credit card billing address.  Thank you!

Name On Card:
Credit Card Type:
Credit Card Number:
Expiration Date:
Billing Street Address:
Billing City:
Billing State:
Billing Zip:

(Your credit card information is being sent over a secure server.)

MPA will provide a full refund prior to the start of this online course,
but cannot give refunds once the course has started.
Once MPA has verified your credit card information,
you will receive an e-mail confirming your registration with
information to access the course.

Return to MPA Home Page