Continuing Education Registration Page


STUDENT INFORMATION

First Name: Last Name:
Email Address: Date of Birth:
Home Address: City, State, Zip:
Home Phone #: Cell Phone #:


EMPLOYER INFORMATION - (Optional)

Business Name: Contact Person:
Address: City, State, Zip:
Phone: Fax:


CHOOSE YOUR COURSE:

Choose Location:
 

 
Choose Session:
 
Course Date(s):
 
Use a comma ( , ) to enroll for multiple dates
Pre-Pay for 24 Credits? (if YES, you save $130 as opposed to paying for each class individually


PAYMENT INFORMATION

Credit Card Number: (Required)

Exp Date:

(Required)

CVV2 Code:

(Required) 
 
Full Billing Address:

(Required)


I have read and accept the terms described HERE.   Initial to Agree:   

 



 

Tuition Fees

3-Credit Course : $50
4-Credit Course: $65
6-Credit Course: $100
24-Credit Package: $350


Did You Know?

Your license expires every 2 years, on the last day of your birth month.

You Need 24 Credits to Renew Your License

3 of 24 Credits Have to be Taken in "Ethics"


Useful Links

- Check Your Credits
- Renew Your License
- Contact the State


HAVE A QUESTION?  

Phone:
    (732) 370 - 8111
E-Mail:




 

Student Links

Check Your C.E. Credits
Enroll for the State Exam
Renew Your License
Contact the Dept. of Insurance
Forms & Documents

Corporate Information

Mailing Address
P.O. Box 579
Lakehurst, NJ 08733-9998
Phone: (732) 370 - 8111
Fax: (732) 370 - 8112

Atlantic School of Insurance

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