Contact us at wise.education@verizon.net © Wise Education, Inc. 2013-2015. All rights reserved.
WISE EDUCATION INC.
NJ, NY, & PA Continuing Education Specialists 1-800-577-9888
MOUNT AIRY
Mount Airy Resort Casino 44 Woodland Road Mount Pocono, PA  18344 877-682-4791 www.mtairycasino.com
There will be no classes held at Mount Airy 2016. Please consider joining us at either our Myrtle Beach getaway or our Atlantic City Blitz.
NJ Locations
PA Locations
To register for multiple locations: Go to registration form    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:_________________________________   __________________________________________
FIRST_______________________MI____   LAST____________________________Jr / Sr / III   DATE OF BIRTH   _  _  / _  _ /  _  _   NJ LIC REF # _  _   _  _   _  _  _ -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
I wish to earn CE credits for the following state(s):
State ___ Lic #______________  Exp _________
State ___ Lic #______________  Exp _________
State ___ Lic #______________  Exp _________