SCSA Classroom Course Registration Request

Please Note

Required fields are marked with an asterisk (*).
Information entered should be as accurate as possible, and about the student enrolling.
This form is a request for registration, only. Students will be contacted by the SCSA to confirm registration and payment information.

1. Personal Information

First Name*

Last Name*

Address*

City*

Province / State*

Postal Code*

Telephone*

Date of Birth*

Email*

I consent to receiving electronic communications from the SCSA

Confirm Email*

Company Name

Company Address

Company Postal Code

Company Phone

PO Number (Direct billing only available for SCSA Members and Supporter Members. Non SCSA members must pre-pay)

2. Course Information

Class 1*

Class 2

Class 3

Class 4

Class 5

Class 6

I have verified that the information above is accurate and genuine.
I understand that by clicking Submit this registration request will be received by SCSA.