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PFHL Professional Training Registration Form
ALL REGISTRATION REQUESTS WILL BE PROCESSED IN THE ORDER RECEIVED. YOU WILL RECEIVE A COPY OF YOUR REGISTRATION BY EMAIL TO VERIFY THAT IT WAS SUBMITTED SUCCESSFULLY.
Email address *
Participant name: *
Your answer
License Type: *
Your answer
Home address (including city and state): *
Your answer
Phone number: *
Your answer
Training requested: *
Payment method: *
Next steps...
Before submitting your request, payment can be made on our website through PayPal (a PayPal account is not required), if desired. Click on the link, then click the PayPal button, which will take you to the PayPal payment site, enter the training name and the listed amount for the training.

http://www.providersforhealthyliving.com/make-a-payment.html

Be sure to submit your registration form after completing payment.

Payment is expected prior to or on the day of the training in order to attend. Thanks for your interest, and check back frequently as more trainings are posted!

A copy of your responses will be emailed to the address you provided.
Please complete the captcha before submitting the form.
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