Course Registration & Payment
Upon receipt of registration & payment, we will email you the link to the course material.
If you prefer to order by mail, click here for a Fax / Mail Order Form

ORDER CONFIRMATION AND PAYMENT INFORMATION

I will be paying for the ExecuRead Online HomeStudy Course by ......
(Check applicable option)

COURSE FEE (or Special Rate Code) :

The ExecuRead HomeStudy Course Fee is US$75  

CURRENCY

US Dollars    

CREDIT CARD (Visa, MasterCard or American Express)

CREDIT CARD INFORMATION (if applicable)

CREDIT CARD TYPE (Check applicable option)

Visa MasterCard American Express

CARDHOLDERS NAME :

CARD NUMBER :

For security reasons, I do not want to include my credit card number here - I will send you my credit card number and my reference number in a separate email or by fax to USA 704.844.0928.  Enter Credit Card number (or reference number if sending card number separately).

EXPIRATION DATE :

LAST 3 NUMBERS ON REVERSE SIDE OF CARD :