Registration for this course is limited to MSEC members only. To join MSEC, click the icon to the right.

You have two options to register for MSEC's e-Learning program

1. Print and fax this form to pay by credit card, or
2. Complete the below information

= Required Field

Choose a Bundle

Options	MSEC Member Price*
Business & Professional/Computer Skills Bundle
20 Course Bundle	$288
Single Course	$89
Legal Compliance or Environmental Safety & Health Bundle
20 Course Bundle	$208
Single Course	$89
*Pricing is per employee/per year based on a two year license. Additional quantity discounts also available. Call 888.432.3077 ext. 102 for additional information.

Please register the following employee:

Please enter name and email address, such as: John Doe, jdoe@company.com

Name:

Organization:

Mailing Address:

City:	State:	Zip:
Telephone Number:	Fax Number:

E-mail Address:

Number of employees: