OnLine Training, Inc

OLT Reseller Registration / Course Purchase Form
Questions or Comments? 1-866-357-0841
Fax form to 1-561-357-4957
Your School or Company's Name:
 
Your Point of Contact's Name:
 
Your (The contact person's)Complete 
Email Address (ie. yourname@isp.com):
 
Your Phone (xxx xxx-xxxx) :

Your FAX (xxx xxx-xxxx) :
 
How would you like to make your
purchase?
Visa  or Master Card or 
Your P/O or Credit Card Number :
 
Exp.Date: 
 
Your Billing Address:
Street:
City: 
State:     Zip Code: 
 
Your Business Address (If Different)
Street:
City: 
State:     Zip Code: 
Choose the reseller program you wish to enroll in:

 Type

Admin Fee

 Special Offer

Sub Total
Individual Reseller  $35.00 Waived with minimum initial purchase of $500  
Instructor Reseller  $35.00 Waived with minimum initial purchase of $500  
Business Reseller  $35.00 Waived with minimum initial purchase of $500  
College Reseller  $35.00 Waived with minimum initial purchase of $150  
Choose the Courses you wish to purchase:

Course Title

Quantity

Purchse Price

Sub Total
Life and Health Pre-Licensing Course      
Life and Health Tutorial      
Life and Health PassPrep      
Property & Casualty PassPrep      
GED - Writing Skills      
GED - Math Skills      
GED - Science      
GED - Interpreting Literature and the Arts      
GED - Social Studies      
   

 Total Purchase -
  $
 
- OnLine Training, Inc. - PO Box 3303, Palm Beach, FL 33480 - http://www.oltraining.com -