2026 Continuing Education Registration

@if(session('success') || request('success'))

Formulario enviado correctamente.

@endif @if(session('error'))

@endif @if($errors->any())

{{ $error }}

@endif

Classes are once a week from 6:30 pm – 10:30pm

@csrf

@forelse($courses as $course) @empty @endforelse

Select	Class Day	CODE	Class Description	Session 1	Session 2	Session 3	Cost
	{{ $course->class_day }}	{{ $course->code }}	{{ $course->description }}	{{ $course->session_1 ?: '-' }}	{{ $course->session_2 ?: '-' }}	{{ $course->session_3 ?: '-' }}	${{ number_format($course->cost, 2) }}
No courses configured. Please contact AATI.

REGISTRATION FORM / Registración (Please use one form per Student / Favor utilizar una planilla por estudiante).

FULL NAME/NOMBRE y APELLIDO *

Title

EMAIL *

D.O.B. Month

D.O.B. Day

D.O.B. Year

S.S.# XXX-XX-

Home Telephone

Work Telephone

Cellular #

Language

Ethnicity/Raza

Address/Dirección *

City/Ciudad *

State

ZIP *

Start Date

End Date

Initials

Payment Information

+ Shipping if applicable $15.00

Check #

Money Order #

Receipt #

Credit Card #

EXP Month

EXP Year / CVV

Name on Credit Card

Credit Card Billing Address

Acknowledgement

I understand I am not registered for the upcoming certification exams.

Yo reconozco que no estoy registrado para los próximos exámenes de certificación.

Policies/Reglas

I accept the policies described on this registration form. Read all policies / Leer todas las reglas

Signatures

Cardholder Signature

Student Signature

Today’s Date

2026 CONTINUING EDUCATION & CERTIFICATIONPREPARATION REGISTRATION FORM

REGISTRATION FORM / Registración (Please use one form per Student / Favor utilizar una planilla por estudiante).

Payment Information

Acknowledgement

Policies/Reglas

Signatures

2026 CONTINUING EDUCATION & CERTIFICATION
PREPARATION REGISTRATION FORM