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DOYLESTOWN
2012 Continuing Education Schedule

 

THE CAMPBELL AGENCY
236 Wells Road
Doylestown, PA 18901
215-348-8661
The Campbell Agencies
THE CAMPBELL AGENCY
Check desired classes:
__ 02/09/12 FLOOD INSURANCE (PA course # 17999)
8am - 12pm
Thurs.
4 CEC'S
$ 63
__ 04/25/12 ETHICAL AGENCY OPERATIONS
9am - 12pm
Wed.
3 CEC'S
$ 53
__ 06/07/12 CLAIMS: AGENCY ASSISTANCE (PA course # 19084)
8am - 12pm
Thurs.
4 CEC'S
$ 63
__ 08/16/12 WORKERS COMPENSATION
9am - 1pm
Thurs.
3 CEC'S
$ 53
__ 10/25/12 CYBER CRIME & INSURANCE
9am - 12pm
Thurs.
3 CEC'S
$ 53

To register online OR for multiple locations:

 

  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 PA  800-577-9888
wise.education@verizon.net
FIRST_______________________MI____
LAST_____________________________
PA INS LIC#___________________________
PA INS LIC EXP DATE  _  _  /  _  _  /  _  _
DATE OF BIRTH   _  _  / _  _ /  _  _
SOC. SEC. #   _  _  _  /  _  _  / _  _  _  _
HOME ADDRESS__________________________
CITY/ST_______________________ZIP_________
HOME PHONE  (  _  _  _  ) _  _  _  -  _  _  _  _
MOBILE PHONE  (  _  _  _  ) _  _  _  -  _  _  _  _
E-MAIL___________________________________
BUS FIRM________________________________
BUS PHONE  (  _  _  _  ) _  _  _  -  _  _  _  _
BUS FAX  (  _  _  _  ) _  _  _  -  _  _  _  _

BUS ADDRESS___________________________
CITY/ST_______________________ZIP_________
 Please make a copy of this form and mark your calendar.
No CE confirmations mailed.
PLEASE ATTACH MEMO AS TO ANY SPECIAL NEEDS

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