PII: Register for Class

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Class Room Courses:
Register for
ClassRoom Courses
CE - Continuing Ed.
PA Pre-Licensing:
Life, Accident
& Health
PA Pre- Licensing:
Property & Casualty
Order: P&C and LAH Self Study Materials
Class Schedules
Training Locations
In-House Training

On-Line Courses:
PA Pre-Licensing:
Securities
CE - Continuing Ed.

Register for Class

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*Address:
Address:
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*ZIP:
	* Indicates Required Field
Company Name:
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*Phone Number:
Fax Number:
*E-Mail:
	A Reply E-Mail will Confirm Your Registration

PLE - Pre-Licensing Education Courses

Life, Accident & Health: PA Pre-Licensing Education Course

$395 Including Materials
Fall Classes To Be Announced

Property & Casualty: PA Pre-Licensing Education Course
Classes Held At:
Holiday Inn Express, South Side (3 Day Course)
$395 Including Materials
July 6, 7 & 8 - 8:00 AM to 5:00 PM

September 28, 29, & 30 - 8:00 AM to 5:00 PM

Fall Classes To Be Announced

CE - CONTINUING EDUCATION COURSE
All Classes: $75 for Four (4) Hours or $135 for Eight (8) Hours
Two or more people from the same organization are eligible for a multi-person discount
2010	LOCATION	TIME	TOPIC	Register
	Pittsburgh	8:30a - 12:30p	Fall Schedule To Be Announced
	Pittsburgh	1:00p - 5:00p	Fall Schedule To Be Announced
	Pittsburgh	8:30a - 12:30p	Fall Schedule To Be Announced
	Pittsburgh	1:00p - 5:00p	Fall Schedule To Be Announced
	Pittsburgh	8:30a - 12:30p	Fall Schedule To Be Announced
	Pittsburgh	1:00p - 5:00p	Fall Schedule To Be Announced
	Pittsburgh	8:30a - 12:30p	Fall Schedule To Be Announced
	Pittsburgh	1:00p - 5:00p	Fall Schedule To Be Announced
	Pittsburgh	8:30a - 12:30p	Fall Schedule To Be Announced
	Pittsburgh	1:00p - 5:00p	Fall Schedule To Be Announced
	Pittsburgh	8:30a - 12:30p	Fall Schedule To Be Announced
	Pittsburgh	1:00p - 5:00p	Fall Schedule To Be Announced

Total $ Amount:
Form of Payment:			Paying by Check:
			Paying by Credit Card: If you are paying by credit card We will contact you for your card information
PRINT PAGE before Submitting Form

Registration will NOT be completed until payment is received in full
Make Checks Payable To: Pittsburgh Institute of Insurance
Mail To: Pittsburgh Institute of Insurance, 4601 Clairton Blvd., Pittsburgh, PA 15236
The Institute accepts personal checks, organization checks or billing authorizations, money orders, VISA, MasterCard, American Express, and DISCOVER
Full refund/credit for classes cancelled/transferred must be in writing 7 days prior to class date
Within 7 days of scheduled class date the following penalty fees will apply: $25 Cancellation/$10 Transfer
The Institute reserves the right to cancel a class if enrollment is not sufficient; all moneys would be refunded.