Course Completion Form
Please complete the information below. We will send you a certificate, and register your credits with the state as soon as we have verified the time spent watching the videos and your section answers.
Name
*
First
Last
Address
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Phone
*
Email
*
TDLR License Number
*
Expiration Date
*
MM slash DD slash YYYY
Comments or Suggestions:
PLEASE PRESS THE SUBMIT BUTTON, not the mark complete button.
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