Registration

(404) 474-8774

888-4ez-Exam

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Workshop Registration Form

* Indicates required field
First Name:*
Middle Initial:
Last Name:*
Job Title:
Company Name:
Shipping Address:*	(We do not ship to PO Boxes)
Unit No.:
City:*
State/Province:*
Zip/Postal Code:*
Contact Phone:*
Business Phone:
Mobile Phone:
Fax:
E-Mail:*
Web Page:

Select the Georgia State exam preparation workshop you plan on attending:*

How did you hear about us?:

	State of Georgia Web Page
	Telecommunication Association
	NBFAA - National Burglar and Fire Alarm Association
	NLVCA - National Low Voltage Contractors Association
	API - Dawn Johnson
	Received Brochure in the Mail
	Received E-Mail
	Web Search Engine (please specify):
	Parts Supply Store (please specify):
	Referred by (please specify):
	Other (please specify):

Fill in the following payment information and press the "Submit" button in order to reserve your seat

Visa MasterCard Checking Account Debit Check or Money Order**

	Credit Card or Checking Account Number:
	Expiration Date:	(mmyy) e.g. 0414

Billing information if different from name/address above:

	Billing Name:
	Billing Address:
	Unit No.:
	City:
	State/Province:
	Zip/Postal Code:

Comments:

► You must apply with the State of Georgia's Low-Voltage Contracting Board in order to receive
approval to take the low-voltage State exam. (Click Here for the State Application)

► This shopping cart system does not automatically charge anything against your credit card.
      All orders are reviewed within 24 hours before fulfillment. You may be contacted by phone
      or email before fulfillment. All book, indexes, and tab orders add 7% sales tax and shipping
      cost (UPS Ground). We will need a physical address to ship book, indexes, and tab orders.

► If you would like to order reference books, tabs and/or indexes please let us know under the
above "Comments:" section or email us at Books@4ezExam.com. Included with the
workshop is a home Study Guide with practice questions which will be mailed to you.

► We never share any of your personal information with anyone. We use your social security
number only to verify your passing of the low voltage contractors exam via your application
status from the State of Georgia professional licensure web page and then we inform you.

*I have read and agree to the Terms and Conditions and understand the cancellation policy.

To contact us: Info@4ezExam.com or Call (404) 474-8774 or (888) 4ez-Exam