test_Enrollment

Complete the required information, download the Enrollment Form, and then
mail, fax (714.777.4267), or telephone (800.995.1747).

Name

Street

City

State

Zip

Phone #

E-Mail Address

The last 6 digits of your SSN are required
if you are taking the 60 Hour Course.

Course Selection #1

Course Selection #2

CA. Tax Preparer Registration #
CPA License #
PA License #
Oregon Tax Consultant #
Oregon Tax Preparer #
Enrolled Agent #
*Certified Financial Planner ^TM License #*

Add Shipping/Handling Charge $11.00 For Each Course Ordered '$6.00' For Internet Course.

My Check or money order for $ is enclosed. Make checks payable to: CALIFORNIA TAX INSTITUTE	I wish to pay by credit card. *Credit Card #* Expiration Date:
	ID Number Where's my Card ID Number? * Required for American Express, Visa, MasterCard and Discover.

Authorized Signature: