National Board Exam Review Course R E G I S T R A T I O N
Course & Registration Fees
Participants Information
Please Select one:
Name_____________________________________________________________________ Session 1 - Science $300.00
Address___________________________________________________________________ Session 2 - Arts $300.00
City__________________________________State________________Zip_____________ Sessions 1 and 2 (Science & Art) $600.00
Phone_______________________________Email_________________________________
Firm Name_____________________________ NFD&MA Member?
Yes
No
Mortuary College Attended________________________________________________
Year Attended__________________________Graduation Date__________________
Tuition Includes:
All printed materials. 7 hours of face-to-face classroom style
review at the NFDMA National Headquarters.
Discussion, question/answers and practice tests.
Catered lunch, snacks, and bottled water. Transportation will be
provided from the hotel where a special nightly rate has been
negotiated.
Emergency Contact___________________________Phone______________________
How many times have you taken the NBE?________________________________
Payment Method
Check/Money Order /Draft (Payable to NFDMA, Inc.)
What do you feel has hindered your success passing the NBE?
_____________________________________________________________________________
Are you a student/apprentice member of NFD&MA?
Designations you have earned:
Upcoming Course Dates
CFSP
Yes______ No_____
CCO
OTHER
Monday, May 14 – Saturday, May 19, 2018
MasterCard
American Express
Discover
Other___________________
Name on Card_________________________________________
Exp. Date______________________CVC Code_____________
Monday, July 10 – Saturday, July 15, 2017
Monday, February 19 – Saturday, February 24, 2018
Visa
Card #_________________________________________________
Select the desired date
Monday, Oct. 16 – Saturday, Oct. 21, 2017
Credit Card Type:
National Funeral Directors & Morticians Association, Inc.
Signature______________________________________________
Email, fax or mail form with payment to: NFD&MA, Inc.
6290 S HANNON P KWY U NION C ITY , GA 30291
E MAIL : NFDMA@ NFDMA . COM | F AX : 770-969-0505