New England February 2023 LT2

IMPORTANT: The host Area has chosen to make this training open to COVID-19 vaccinated individuals only.

This training will use the CCP Co-Creative Contribution Process for participant tuition, with a deposit followed by a balance payment at the end of the training.

If the information in the registration fields below is not automatically filled in, please log into MKPConnect first then reload this page. This will populate the form with your information. Not doing so will create a data error. If you have difficulty please contact Support Services for assistance.

Your Registration Info - U.S.

Email Address *

First Name *

Last Name *

Street Address *

City *

Country *

State / Province *

Zip/Postal Code *

Phone *

Birth Date *

Emergency Contact Name *

Emergency Contact Phone *

Event Fee(s) *

Participant Tuition Deposit (PROJECTED COST $520) - $ 200.00

Please contact me about payment - $ 0.00

Credit Card Information

Card Type

Card Number *

Security Code *

Expiration Date *

My billing address is the same as above

Billing Name and Address

Billing First Name *

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