FL-FCASV

Training Event Registration

Event Date

October 26 - 30, 2026

Event Time

08: 00 AM - 05: 00 PM (Eastern Standard Time)

Attendee Contact Information

Provide your contact information. First name, last name and email address are required.

First Name *

Middle Name

Last Name *

Suffix

Pronouns

Organization *

Street Address

Street Address 2

City *

State *

Zip Code *

Country

Email * Registration with this email has already been done

Confirm Email *

Phone *

Extension

Attendee Additional Information

Attendee Additional Information Description

Other Occupation *

Job Title *

Certification ID / professional license # (if applicable)

CEU

CEU

Hours Requested *

Nursing (Max available: 40)

Same as above

Billing Contact Information

First Name *

Middle Name

Last Name *

Suffix

Pronouns

Organization *

Email * The payment email is different from the account email. If this is intentional, no action is needed. Otherwise, please review before proceeding.

Phone *

Billing Address

Street Address 1 *

Street Address 2

City *

State *

Zip *

Country *

Notes related to this payment

Payment Options

All required fields in the Billing Information must be entered before the payment options are displayed.

Auto-renew my membership annually

Total Fee

There are errors. See at the end of the page for details. Please fix them before submitting.

OwnershipType *

AccountType *

AccountNumber *

RoutingNumber *

Credit Card # *

Expiration Month *

Expiration Year *

CVV *