Federation of Insurance Women of Texas, Inc.: FIWT Online CE Course Registration

Course Registration Form

Thank you for registering to attend a FIWT online CE course. We appreciate your support as we adapt to the needs of our members. Please complete the form below. If registering for more than one class, please enter all class dates.

Please complete the form below to register online:

* ALL fields are Required

Registration Information
First Name:	Last Name:
Address:
City:	, State: Zip:
Phone:
Email:
TDI License Number:
Date of class or classes you are registering for:

Payment: Classes are $25 for FIWT members and $35 for nonmembers.
When you have completed the fields above, press the "Submit Registration" button below and a confirmation screen will then appear with a Pay By Credit Card link for Square.com that you can use to charge to your credit card.
**FIWT Members: If you have a credit from the FIWT convention this year, please submit this form and we will contact you in regards to credits/payments.