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First Name: Last Name: Organization:

If Billing Name is different, please provide information below:
Billing First Name: Billing Last Name:  
 

Address 1:  
Address 2 (if necessary):
City: State: Zip (5 digits):
Phone:
Email Address:

I would like to purchase: Item: Official FMCSA Medical Examiner Accredited Certification Course
Select Quantity:
Cost Without Discount: $485.00 per license
If you have a corporate code or special offer code, please enter this code in the designated box below. Any pricing modifications will be displayed once the Proceed with Order button is clicked.

Please enter the email address for the individual(s) that will be using each course license (i.e., a Quantity of 3 would require that 3 addresses be entered).

If you are purchasing for multiple individuals, one license per individual must be purchased.

Each license links directly to a single email address and enables one serialized certificate for testing eligibility.

Participant 1 Email Address:
Participant 2 Email Address:
Participant 3 Email Address:
Participant 4 Email Address:
Participant 5 Email Address:

*Participants will be emailed with instructions once the payment has been processed and the account has been set-up.

Discounts are available for volume licenses
(6 to 20,000 users).

To obtain discount pricing please email:
courseinfo@medpro.infotecpro.com
APPLY CORPORATE OR PROMOTIONAL CODE

(If Applicable)
 
ORDER TOTAL TO BE GENERATED: