Learning Module Non-Member Registration Form

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—Rev. Martha Rogers, pastor

Learning Module
Registration Form
for Non-Members

Non-WEOI members may participate in the WEOI Directed Self-Study Learning Modules for continuing professional education credit by registering for selected modules and paying a registration fee. To register online fill out the form below, or call 502.459.2370. After registering for a learning module you will receive a Username and Password to enable you to access the module.

Each Learning Module is $40.

If you ever need assistance with your registration or desire information about the activities, work, and membership of the Oates Institute, please email us (charlotte@oates.org), or call us at (502) 459-2370.

Step 1: Who you are

Name:

Email Address:

Title:

Organization/Company:

Street Address:

City: State: Zip:

Country

Phone:

Fax:

Step 2: Select Learning Module

Learning modules are $40 for non-members

Step 3: WEOI Membership Option

I wish to become a WEOI Member, please bill my credit card listed below for $120 (students: $60)
-- Learning modules are FREE with membership
or $40 per module for non-members.

School or Program if student:

I do not wish to become a WEOI Member,
please bill my credit card listed below for $40 for the selected Learning Module.

Step 4: Payment Information

Gift Certificate Number:

or Credit Card:

Card Number:

Card Type:

Name on Card:

Expiration Date:

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May 5