Class Registration Form

COMPLETE,  PRINT & FAX TO 1-775-522-2520

LCS
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Training Group
Last Name:     First Name:    M.I. 
Street Address:    Apt No.:    P.O. Box: 
City:    State:     Zip Code:   
Telephones: Home:    Office:    Mobile/Cell: 
Email Address:    Alternate email address: 


PLEASE CHECK YOUR CLASS CHOICES BELOW:
                       Class Choice                           Class Price                  Class Dates

  All-Lines Adjuster Pre-License Certification     $399      Class Start Date: 
  Basic Property Estimating, 1 Day                    $159      Class Start Date: 
  Xactimate Estimating,  3 Days                        $359      Class Start Date: 
Payment Method:

  Personal Check       Company Check       Cash       Credit/Debit Card
(Note:  if paying by personal check, please put driver's license number on top of check.  Thank you).
If you are paying by credit/debit card, please complete the form below.  Thank you.
credit cards

Credit/Debit Card Information:

  VISA        MasterCard                     Security Code: (3 digits on back of card) 
  American Express                                Security Code: (4 digits on front of card) 
Card Number:                           Expiration Date: 
Billing Address: 
City:      State:     Zip Code:    

LCS Training Group may charge my credit/debit card for the cost/s of the selected class/es.

Signature: ____________________________________________  Date: ________________________

Please complete the above information, print and fax it to 1-775-522-2520.  We will confirm receipt by either email or phone call.  Thank you.

  

 
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