CounselingCEUsOnline Registration

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Name:________________________________________________________________________

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Address:______________________________________________________________________

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City/State/Zip:_________________________________________________________________

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Telephone Number: ____________________________________________________________

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E-Mail: ______________________________________________________________________ ========================================================================================================= 

Print out this page and fill in the information. This page is for registration only!  You must be registered to begin a course.  No examinations are released unless you are first registered for the course. Register for each course below, order the textbook from the Bookstore, and begin study of the book and the on-site materials.  When you are prepared to take the examination, you may take the exam by printing out the EXPRESS Exam from counselingceusonline.com . Complete the exam and send it back to us by FAX [1(717)597-2302], or by mail [Exams, CounselingCEUsOnline , 8864 Lorford Drive, Chambersburg, PA 17201-9335. 17201-9335]. Remember, no exams are scored until the entire course fee is paid by you in full. When you have paid the required course fee, signed a copy of the Honor Pledge, submitted a course evaluation fee and passed the examination with a satisfactory score, continuing education clock hour credit will be awarded.  You will receive a letter of congratulations, a sealed official certificate indicating the course you completed and the number of clock hours awarded, and an official transcript of your work.

Please list the course(s) for which you are registering and you intend to complete:

Course Number       Course Title                                                          Contact Hrs  Cost         

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Student Signature:___________________________________    Date:______________