Palm Beach State College at OnLine Training

Online Registration Form
(866) 357-0841

We Gladly Accept...

Notice: This online registration for Palm Beach State 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)
Life, Health, and Variable Annuity
$119.00	INS003FL40	40hr 2-15 Life Health and Var Ann Pre-Licensing Course (ONLINE ONLY)

Student Information (bold* entries are required)*
Student's Full Name:	*(Required)*
E-mail Address:	*(Required)*
Social Security Number:	*(Required)*
Date of Birth (mo/day/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

• Withdrawal prior to the start of the first class: full refund.
• Withdrawal after the first session: no refund.
• Non-attendance does not constitute a refund request.

Last Updated: August 19, 2010 by Melody Schiesl