ACTIVITY DIRECTOR TRAINING REGISTRATION "*" indicates required fields Step 1 of 6 - Basic Information 16% Unique IDEvent Description* Membership*Choose your membership typeNNFANALANNFA and NALANon-MemberFacility/Company* Facility/Company Address* Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Facility/Company Phone* Book Purchase Requirement*A separate book purchase is required for this Home Study course. CLICK HERE for more information about purchasing the book. I understand this requirement Tuition* Price: Fees (member)* Price: Fees (non-member)* Price: Total Social Security Number* HiddenSSN Hidden* A student’s Social Security number is required as a condition of enrollment. A student’s Social Security number constitutes an “educational record” under the Federal Educational Rights and Privacy Act (FERPA). That information will be disclosed only with the consent of the student or in those very limited circumstances when consent is not required by FERPA.Name* First Last Home Address* Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Phone (Day)*Phone (Evening)*E-mail Address*This is how we will send you information. Date of Birth* MM slash DD slash YYYY Gender Male Female County* Maiden Name RaceWhite / non-HispanicAsian / Pacific IslandBlack / African AmericanHispanic / LatinoNative AmericanOtherVeteran Status or Dependant Using Military Benefits? Yes Nebraska Resident Yes College CreditIf requesting credit hours, must have high school transcript or equivalent on file with the Learning Center. Yes Terms of Service* I agree to the Terms of Service Cardholder Address* Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Cardholder's Email* HiddenCardholder Name* Do you have a Scholarship or Coupon code? Yes Coupon* Total amount to be charged to Credit Card HiddenTotal CostCredit Card American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Date Month Month010203040506070809101112 Year Year20232024202520262027202820292030203120322033203420352036203720382039204020412042 Security Code Cardholder Name Review Your Selections Click "Previous" to make changes. Click "Submit" to process your registration(s). {all_fields:exclude[58]}
