Online Registration Form
(866) 357-0841
We Gladly Accept...
Notice:
This online registration for Okaloosa-Walton College is processed through OnLine Training's secure server at CyberSource. Your student information is entered on this screen. On the next screen you may review your order. Following that, you may enter your Credit Card information and complete the transaction (within the secure server).
Course Information
Select one or more courses by clicking the checkbox:
(Required)
$84.00
14 hr CE Life
$84.00
14 hr CE Health
$150.00
40 hr 2-15 Life Health and Variable Pre-Licensing Course
$40.00
Review for 2-15 Exam OnLine (Life and Health PassPrep Course)
$400.00
200 hr 2-20 General Lines Pre-Licensing Course
$80.00
Review for 2-20 Exam OnLine (Property & Casualty PassPrep Course)
Student Information
(
bold
entries are required)
Student's Full Name:
(Required)
E-mail Address:
(Required)
Social Security Number:
(Required)
Date of Birth
(day/mo/yr):
(Required)
Contact Phone, with Area Code:
(Required)
Alternate Phone, with Area Code:
After we receive your registration and process the charge, we will send the login and password information for each course registered to the student e-mail address above. Please allow one business day for processing.
Refund Policy
• Full refund if withdrawal is within 24 hours of registration.
• No refund if withdrawal is after the first 48 hours.
• Non-attendance does not constitute a refund request!
Last updated July 19, 2006
by Max Combs
OnLine Training, Inc.