Course Order – Professional Electricians Code Training (PECT)

First Name
Last Name
License #
Address
(where you receive your cc bill)
City / Zipcode
Phone
Email
Contractor Employer
Course Name
Course Date
Credit Card Information *(See Credit Card Policy below)
Credit Card Number
CC Expiration /
CC security code
(on back of card)

* CREDIT CARD POLICY: Your credit card will not be charged until the day before the event and only after your order is reviewed and verified.