Enrollment Agreement (Broker)

Broker Application

    Class Information:

    Brokerage Management Classes:

    8:30AM - 4:40PM

    Choose Options for each (4) boxes below▼

    Brokerage Management (3A)

    Select »


    CONFIRM Brokerage Management

    Confirm »

    Brokerage Exam Prep (3B)

    Select »


    CONFIRM Brokerage Exam Prep

    Confirm »

    * indicates REQUIRED fields below

    Student Information:

    Have you attended classes here before? * YesNo

    Social Security Number: *

    Payment Information:

    Payment Choices explained:

    TUITION options:

    • Either FULL Amount (or) DEPOSIT will hold your seat in class; balance due by 3pm on the Thursday before class begins.

    • Credit Card is required for all ONLINE submissions.

    • Checks, Cash, and Money Orders accepted at the office or by mail.

    TEXTBOOK options:

    • Materials included in price

    • To get a head start, you can request the book before class: (recommended)

      • {option: Mail Book}

        We will mail book to the address provided on this form. (includes $10 for shipping fee.)
        -- OR --

      • {option: Office Pickup}

        Come by the office to pick book up (no charge)

      • *Take note: there is no book for the 3A class

    • Book will be given at class, if {option: At Class} is selected


    CHARGE to Credit Card: * «« VISA or MasterCard ONLY

    Card #: *

    3-digit security code: *
    Expiration Date (MM/YY): *

    Name on Card: *
    Billing Address Number (used to process credit card): * (numbers ONLY)
    Billing Zip Code: *

    Acceptance of Terms and Policies: *

    (check both boxes below to accept, after reading the Terms and Policies)

    , I understand the Terms and Policies as part of this agreement. I am keeping a copy for my records.

    , I understand #2 of the Terms and Policies require me to give timely notice or forfeit $75 if I do not show.