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Certification Training Registration
Certification Training Registration Form
Please fill out this form to register for certification training. To guarantee your place, please arrange payment within 1-2 business days of submitting your registration form. Once payment is received, you will be sent an email confirming the details of the course.
Today's Date
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I am registering for:
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Please select the training event that you are registering for.
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Choose a training
Train the Trainer [Level 1]
Train the Trainer [Level 2]
Administrator/Leader [Level 1]
Administrator/Leader [Level 2]
Crisis Response & Management
Your Name
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First Name
Last Name
Address
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Please fill in your personal address, your organization's address is requested later.
Street Address
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Address Line 2
City
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Province / State / Region
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Postal Code / Zip
Antigua and Barbuda
Bahamas
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Trinidad and Tobago
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Guyana
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Albania
Andorra
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Azerbaijan
Belarus
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Bulgaria
Croatia
Cyprus
Czech Republic
Denmark
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Finland
France
Georgia
Germany
Greece
Hungary
Iceland
Ireland
Italy
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Liechtenstein
Lithuania
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Montenegro
Netherlands
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Portugal
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Spain
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East Timor
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Japan
Jordan
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Maldives
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Nepal
Oman
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Philippines
Qatar
Russia
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Singapore
Sri Lanka
Syria
Taiwan
Tajikistan
Thailand
Turkey
Turkmenistan
United Arab Emirates
Uzbekistan
Vietnam
Yemen
Australia
Fiji
Kiribati
Marshall Islands
Micronesia
Nauru
New Zealand
Palau
Papua New Guinea
Samoa
Solomon Islands
Tonga
Tuvalu
Vanuatu
Algeria
Angola
Benin
Botswana
Burkina Faso
Burundi
Cameroon
Cape Verde
Central African Republic
Chad
Comoros
Congo
Djibouti
Egypt
Equatorial Guinea
Eritrea
Ethiopia
Gabon
Gambia
Ghana
Guinea
Guinea-Bissau
Côte d\'Ivoire
Kenya
Lesotho
Liberia
Libya
Madagascar
Malawi
Mali
Mauritania
Mauritius
Morocco
Mozambique
Namibia
Niger
Nigeria
Rwanda
Sao Tome and Principe
Senegal
Seychelles
Sierra Leone
Somalia
South Africa
Sudan
Swaziland
Tanzania
Togo
Tunisia
Uganda
Zambia
Zimbabwe
Country
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Your Email
*
Your Personal Phone Number
*
Preferred Language
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English
French
Bilingual
Organization Name
*
Name of the organization that you are working for/volunteering at.
Organization Address
*
Please fill in your organization's address.
Street Address
*
Address Line 2
City
*
Province / State / Region
*
Postal Code / Zip
Antigua and Barbuda
Bahamas
Barbados
Belize
Canada
Costa Rica
Cuba
Dominica
Dominican Republic
El Salvador
Grenada
Guatemala
Haiti
Honduras
Jamaica
Mexico
Nicaragua
Panama
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Trinidad and Tobago
United States
Argentina
Bolivia
Brazil
Chile
Columbia
Ecuador
Guyana
Paraguay
Peru
Suriname
Uruguay
Venezuela
Albania
Andorra
Armenia
Austria
Azerbaijan
Belarus
Belgium
Bosnia and Herzegovina
Bulgaria
Croatia
Cyprus
Czech Republic
Denmark
Estonia
Finland
France
Georgia
Germany
Greece
Hungary
Iceland
Ireland
Italy
Latvia
Liechtenstein
Lithuania
Luxembourg
Macedonia
Malta
Moldova
Monaco
Montenegro
Netherlands
Norway
Poland
Portugal
Romania
San Marino
Serbia
Slovakia
Slovenia
Spain
Sweden
Switzerland
Ukraine
United Kingdom
Vatican City
Afghanistan
Bahrain
Bangladesh
Bhutan
Brunei Darussalam
Myanmar
Cambodia
China
East Timor
India
Indonesia
Iran
Iraq
Israel
Japan
Jordan
Kazakhstan
North Korea
South Korea
Kuwait
Kyrgyzstan
Laos
Lebanon
Malaysia
Maldives
Mongolia
Nepal
Oman
Pakistan
Philippines
Qatar
Russia
Saudi Arabia
Singapore
Sri Lanka
Syria
Taiwan
Tajikistan
Thailand
Turkey
Turkmenistan
United Arab Emirates
Uzbekistan
Vietnam
Yemen
Australia
Fiji
Kiribati
Marshall Islands
Micronesia
Nauru
New Zealand
Palau
Papua New Guinea
Samoa
Solomon Islands
Tonga
Tuvalu
Vanuatu
Algeria
Angola
Benin
Botswana
Burkina Faso
Burundi
Cameroon
Cape Verde
Central African Republic
Chad
Comoros
Congo
Djibouti
Egypt
Equatorial Guinea
Eritrea
Ethiopia
Gabon
Gambia
Ghana
Guinea
Guinea-Bissau
Côte d\'Ivoire
Kenya
Lesotho
Liberia
Libya
Madagascar
Malawi
Mali
Mauritania
Mauritius
Morocco
Mozambique
Namibia
Niger
Nigeria
Rwanda
Sao Tome and Principe
Senegal
Seychelles
Sierra Leone
Somalia
South Africa
Sudan
Swaziland
Tanzania
Togo
Tunisia
Uganda
Zambia
Zimbabwe
Country
*
Organization Phone Number
*
Your Title or Role
Status
*
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Full Time
Part Time
Volunteer
Organization Website
Organization Type
*
Please select the type of organization that best describes the organization you are registering under.
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Business
Not-for-Profit
Church
School
Camp
Sporting Club
Ministry
Denomination Office
Insurance Company
Independent Instructor
Denomination & Referral Partners
*
Licensed denominations qualify for a 10% dcount on services of Plan to Protect®.
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Christian & Missionary Alliance
Pentecostal Assemblies of Canada
Pentecostal Assemblies of Newfoundland & Labrador
Evangelical Missionary Church of Canada
Fellowship of Evangelical Baptist Church of Canada
Evangelical Free Church of Canada
Anglican Network in Canada
Society of Saint Pius X
Canada Central District - Nazarene Church in Canada
United Church in Canada
Free Methodist Church in Canada
Canadian Conference of Mennonite Brethren
Church of God in Eastern Canada
Other (no discount applies)
Name of Director/Senior Pastor/Principal
*
Email of Director/Senior Pastor/Principal
*
Plan to Protect® Membership Status
*
Yes we are a member
No we are not a member
Unsure
Required Text (not included in the registration fee) - Plan to Protect® Manual (2010 ed. or newer) Hard Copy
*
Additional shipping charges may be applied.
I have a copy of the Plan to Protect® Manual (2010 ed. or newer)
I need to purchase a copy of the Plan to Protect® Manual
Unsure
Knowledge of Plan to Protect®
*
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I know Plan to Protect® well.
I'm moderately familiar with Plan to Protect®
I'm new to Plan to Protect®
I'm re-certifying my Plan to Protect® training
Who may we thank for referring you to Plan to Protect® Certification Training?
How would you like to pay for your course(s)?
*
Credit Card (I will call your office to pay)
Credit Card (send me a link to pay online)
PayPal (email me a PayPal invoice)
Email Transfer (via online banking)
This training is included in my Implementation/Going the Distance membership
Consent
For our Canadian Clients: With Canada's anti-spam legislation we are required to obtain your consent to send you electronic communications. We do need express permission from each individual within an organization that we are communicating with.
You may unsubscribe or withdraw your consent at any time by contacting us at Plan to Protect® 117 Ringwood Dr., Unit 11, Stouffville, ON L4A 8C1, or emailing us at info@plantoprotect.com.
Please confirm your consent to receive electronic communications from Plan to Protect® as described above. This consent will be considered as consent of the registrant.
Yes I give my consent for Monthly e-Newsletters only
Yes I give my consent for all e-communication
No I do not give my consent
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