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BRANCHVILLE
2009 Continuing Education Schedule

 

Selective Insurance Company
Corporate Entrance
40 Wantage Avenue
Branchville, NJ 07826
973-948-3000

Check desired classes:  
__ 05/21/09 PROPERTY FRAUD II
9am - 12pm
Thurs.
__ 05/21/00 PAIP/CAIP ** Special pricing is $75
1pm - 5pm
Thurs.
__ 09/10/09 DWELLING INSURANCE  
9am - 12pm
Thurs.
__
 09/10/09 REINSURANCE IN TODAY'S WORLD
1pm - 4pm
Thurs.

ALL NJ CE Courses listed qualify for 3 NJ CE credits.

 Course also qualifies for 3 New York CE credits.
($10 Addt'l Fee)
Course also qualifies for 3 Pennsylvania CE credits.
($10 Addt'l Fee)

# of
classes
Tuition

# of
classes
Tuition
1
$70
6
$300
2
$110
7
$350
3
$165
8
$400
4
$220
9
$450
5
$250
10
$500

Early Birds - Deduct 10%
(postmarked 20 days prior to class)
 

  To register by mail or fax for this location ONLY,
  follow these steps:
1. Print this page.
2. Check desired classes.
3. Fill in required information and send to:

Wise Education, Inc.
1501 Cobblestone Ct.
Thorofare, NJ 08086
Fax: 856-384-8414
Tuition Total $________  # of Credits______________
PAYMENT OPTIONS:
____Check #_________ Check amt. $___________
____Visa    ____MC    ____Discover
Expiration Date _____/______(Required)
CC #______________________________________

Cardholder Name_____________________________
                                                      (Please print)
Signature____________________________________

 Comments:__________________________________

____________________________________________ Wise Education of NJ 800-577-9888
wise.education@verizon.net
FIRST_______________________MI____
LAST____________________________Jr / Sr / III
DATE OF BIRTH   _  _  / _  _ /  _  _
SOC. SEC. #   _  _  _  /  _  _  / _  _  _  _
NJ LIC REFERENCE # _  _   _  _   _  _  _ -IP
NJ INS LIC EXP DATE  _  _  /  _  _  /  _  _
HOME PHONE  (  _  _  _  ) _  _  _  -  _  _  _  _
MOBILE PHONE  (  _  _  _  ) _  _  _  -  _  _  _  _
HOME ADDRESS__________________________
CITY/ST_______________________ZIP_________
BUS FIRM________________________________
BUS PHONE  (  _  _  _  ) _  _  _  -  _  _  _  _
BUS FAX  (  _  _  _  ) _  _  _  -  _  _  _  _
BUS ADDRESS___________________________
CITY/ST_______________________ZIP_________
E-MAIL___________________________________
 Please make a copy of this form and mark your calendar.
No CE confirmations mailed.
PLEASE ATTACH MEMO AS TO ANY SPECIAL NEEDS
PENNSYLVANIA CE

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