Christian Health Service Corps

STEP ONE
ENTER INFO
STEP TWO
CONFIRMATION
STEP THREE
RECEIPT

Thank you for registering for Global Health & Tropical Medicine Overview - ONLINE. Live interactive course sessions are scheduled online on Tuesdays and Thursdays, between July 9th, 2024 and August 13th, 2024. There will also be one Saturday session on August 10th, 2024 from 8:00am-1200pm. To allow time for Q&A and Announcements, Tuesday course time is scheduled 6:30pm-8:30pm CT and Thursday course time is scheduled 12:30pm-2:30pm CT. Detailed course access and logistics information will be emailed to registrants within the two weeks before the course or session start date.

The complete schedule is accessible at your convenience in the training section of our website.

Payment options:

You may choose to:

pay the full course registration fee of $640 today

OR make a deposit of $75 toward the full course registration fee (information on setting up payments toward the balance will be emailed to you)

(Please note that all session times are listed in central time = CT)

Pay course registration fee in full today

$640.00

Please check only this box and proceed to the Registrant or Donor/Payer Information section.

Reserve a spot in the course with a deposit

$75.00

Please check only this box and proceed to the Registrant or Donor/Payer Information section.

Total: $0.00

Registrant Information
(If different than donor/payer)

Registrant First Name:

Registrant Last Name:

Registrant Address:

Registrant City:

Registrant State:

Registrant Zip Code:

Registrant Email:

Registrant Home Phone Number:

Registrant Cell Phone:

Please select which type of certificate you would like upon completion of training. *

Donor/Payer Information

First Name: *

Last Name: *

Billing Address: *

This is the address where your credit card statements are mailed.

Address 2:

City: *

State / Province: *

Zip Code: *

Country: *

Home Phone Number:

Cell Phone Number: *

E-mail: *

A receipt will be e-mailed to this address.

Your Payment Information

Name on Card: *

Card Number: *

Security Code: *

Expiration Date: *

Name on Account: *

Routing Number: *

Account Number: *