Certified Insurance Service Representatives (CISR)
Registration Form

Fields in Yellow are Required




This is my first CISR class        This is my annual CISR designation update
I am working towards CISR Elite Designation.

To register for a class, click the checkbox next to the Course Title and then select the Class Date and City

Course Title: Class Date and City:

Registration Fee is $175.00 per Class
NEW CANCELLATION POLICY FOR 2023 — Cancellations received within 3 days of the class will incur a $25.00 non-transferable fee. No-shows will forefit the entire registration fee.

Payment Information: Payment is due prior to the class — late payments will be assessed a $25 fee.
Method of Payment:   
Visa     MasterCard     American Express     Check
A 3% Processing Fee Will Be Charged To All Credit Card Transactions.
Registration Fee for Classes Selected Above: $0.00
By checking this box and submitting this form, you authorize and commit to the payment of $0.00 for CISR class registration, per the cancellation policy described above.