lasorsa training header logo

Select Course

Course Location

Course Dates

Full Name

Date of Birth

Email Address

Phone Number

Please leave this field empty.

Company

Billing Address

City

State

Zip Code

Country

Exact Name for Certificate

Remarks / Requests

Referred From?

Payment Method
-PayPal, Credit Card, Debit Card: Complete this form and click 'Submit' below, then process payment by selecting the desired course below this form and click the 'Pay Now' button.
-If by Check: submit this form and contact us for further instructions.

Electronic Signature
Name entered in the signature box below (must match cardholder's information) authorizes LaSorsa & Associates to accept full payment of the course registration fee selected above. Payment must be made in full in order to complete the registration unless a payment plan has been authorized. No refunds once confirmed – you may request to attend another course at a later date within 12 months. If hotel package is selected and registration confirmed, deferring to another course date may add additional costs/fees.


*Ensure to submit a completed form above, then make payment below to complete your registration. A PayPal account is NOT required to make payment below.


Select One




*In order to maintain compliance with ITAR&§120.9 registrants may be subject to an identity and legal status verification. Prior to the first day of class, you will be required to provide proof of citizenship or legal status. Additionally, although our courses are open to the general public, if you have a felony conviction on your record, you may face licensing and permit restrictions in most states – this is for your awareness only – Registration fees are non-refundable.*