Please register the following individual(s) for: Medical Billing and Medical Records Management
July 30 - 31, 2020
ONLINE
Individual Tuition Rate (U.S. Funds Only): $849
Advanced payment by credit card, check or electronic payment (via ACH) is required. Registrations must be received 10 business days before the class start date. After this date, registrations will be taken on a space-available basis and a $25 late registration fee will be charged. For complete registration policies, please visit www.falmouthinstitute.com/faq.html

You may register up to three people from the same organization online. If you would like to register more than three people, please call Customer Care at 1-800-992-4489 for a significant group discount.
All fields marked with * are required to complete registration.

First Name*
Middle Initial
Last Name*
Organization*
Title*
Department*
Address*
City*
State*
Zip*
Phone*
Ext.
Fax*
Email*
How did you first hear about this product?*

Scroll down to register more people or click here to enter billing information.
A UNIQUE EMAIL IS REQUIRED FOR EACH REGISTRANT.

Full Name
Title
Department
Phone
Ext.
Fax
Email - A unique email is required for each registrant.
Full Name
Title
Department
Phone
Ext.
Fax
Email - A unique email is required for each registrant.

Billing Contact Name*
Address*
City*
State*
Zip*
Phone*
Ext.
Fax*
Email

Choose one of the following options*:

Credit Card - Fill out the section below (all fields are required).
Check - Review Falmouth's registration policies.
ACH - Please use the following account and routing numbers:
Account number: 40630491
Routing/transit number: ABA 021052053

CREDIT CARD INFORMATION
If paying by credit card, you must fill in ALL fields in this section to complete your registration (including security code).
Name on Card
Card Number
Expiration Date
Security Code
Card Type
Total Amount

ABOUT SSL CERTIFICATES

How to Find the Security Code: For Visa and Master Card, the security code is the last 3 digit number located on the BACK of the card on or above the signature line. For an American Express card, the security code is the 4 digits on the FRONT of the card above the end of the card number.

My credit card billing address is different than the address above.


I have read, understand, and agree to Falmouth's registration policies.*
All fields marked with * are required to complete registration.