licensure

Licensure Review Course

August 28 & 29, 2026

$125.00

Registration Form

Fields marked * are required.

Registration Option

Two Days

Licensure Review Course — August 28 & 29, 2026

$125.00

Personal Information

First Name *

Last Name *

Address

Street Address

Address Line 2

City

State

ZIP Code

Contact Information

Home Phone

Cell Phone

Email Address *

School Affiliation

I am enrolled at *

You will be directed to payment after submitting this form.

Date

August 28 & 29, 2026

2-day course

Location

Founders Hall F124

Waterbury, CT

Onsite

Registration Fee

$125.00

Payment collected at checkout

Questions?

Contact your program director or reach NEPTAC through the member portal.