Castle-Rogers' Order Form - Customer Appreciation Code 2778

YOUR ORDER

Thank you! Your order number is {{orderInformation.orderNumber}}.

{{item.name}}

{{item.subtitles.Location}} — {{item.subtitles.EventCode}}
{{item.subtitles.Date}} — {{item.subtitles.UtcTimes | formatUtcTimes}}

{{item.subtitles.Description}}

{{item.secondaryMessage}}

Price
{{item.listPrice}} {{item.itemPrice}}

Total
{{item.total}}

Qty:

Add Special Offer

{{item.numberOfComponents}} Item Items Included, {{item.listPrice}} Value

{{component.name}} ({{component.subtitles.Format}})
{{component.subtitles.Description}}

Learner #{{index+1}}

{{registrant.data.firstName}} {{registrant.data.lastName}}

Learner #{{index+1}}
(select one)

{{radioButtonNameLabel(adr)}} {{showEmailAddress(filterLearners(registrant, item, items), adr)}}

Salutation
Valid salutation is required.

Other
Must provide the other salutation.

First Name
Valid first name is required.

Last Name
Valid last name is required.

Email Email address essential for training setup
Valid email address is required.

Job Title
Title is required.

ORDER SUMMARY
- {{line.name}}
  
  {{line.valueDisplay}}
- {{line.name}}
  
  {{line.valueDisplay}}

p: {{address.data.phone}}

{{address.data.city}} {{address.data.state}}, {{address.data.zip}}

Salutation

Valid salutation is required.

Other

Must provide the other salutation.

First Name

Valid first name is required.

Last Name

Valid last name is required.

Valid email address is required.

Phone

Phone is required.

Company

Please enter your company.

Job Title

Please enter a valid title.

{{address.data.city}} {{address.data.state}}, {{address.data.zip}}

Address

Please enter your address.

Address Line 2

City

Country

Please select a valid country.

State

Please provide a valid state.

Zip Code

Zip code required.

p: {{address.data.phone}}

{{address.data.city}} {{address.data.state}}, {{address.data.zip}}

Salutation

Valid salutation is required.

Other

Must provide the other salutation.

First Name

Valid first name is required.

Last Name

Valid last name is required.

Valid email address is required.

Phone

Phone is required.

Company

Please enter your company.

Job Title

Please enter a valid title.

{{address.data.city}} {{address.data.state}}, {{address.data.zip}}

Address

Please enter your address.

Address Line 2

City

Country

Please select a valid country.

State

Please provide a valid state.

Zip Code

Zip code required.

SHIPPING METHOD

{{option.name}}: {{option.price}}
{{option.message}}

p: {{address.data.phone}}

{{address.data.city}} {{address.data.state}}, {{address.data.zip}}

Salutation

Valid salutation is required.

Other

Must provide the other salutation.

First Name

Valid first name is required.

Last Name

Valid last name is required.

Valid email address is required.

Phone

Phone is required.

Company

Please enter your company.

Job Title

Please enter a valid title.

{{address.data.city}} {{address.data.state}}, {{address.data.zip}}

Address

Please enter your address.

Address Line 2

City

Country

Please select a valid country.

State

Please provide a valid state.

Zip Code

Zip code required.

PAYMENT

Credit card

Invoice

Name on card Full name as displayed on card
Name on card is required

Credit card number
Credit card number is required

MM Expiration
Expiration month required

/
YYYY
Expiration year required

CVV
Security code required

Purchase Order Number (Optional)
Purchase Order Number

If your organization is tax exempt, please email your tax exempt certificate to pryortax@pryor.com or send by fax to 913-967-8849 referencing your confirmation number. The tax amount will be deducted from the invoice(s) once we have received your exemption certificate. Services are taxable in Hawaii, South Dakota, West Virginia, some Alaska local jurisdictions, and Canadian provinces.
- {{line.name}}
  
  {{line.valueDisplay}}
- {{line.name}}
  
  {{line.valueDisplay}}

Payment Information

Purchase Order #: {{orderInformation.purchaseOrderNumber}}

Note: Invoices for seminars are emailed to the attendee email address(es) listed above. An invoice for remaining items will be mailed to the "{{addresses['orderedBy'].name}}" address listed above.
Card Type: {{orderInformation.paymentMethodName}}

Card Number: {{orderInformation.cardNumber}}

Name on Card: {{orderInformation.cardName}}

Purchase Order #: {{orderInformation.purchaseOrderNumber}}

Note: Charges associated with this invoice will appear as "Fred Pryor & CareerTrack" on your credit card statement.

YOUR ORDER

{{item.name}}

{{line.name}}

{{line.name}}

{{address.name}}

{{address.name}}

{{address.name}}

{{address.name}}

SHIPPING METHOD

{{address.name}}

{{address.name}}

PAYMENT

{{line.name}}

{{line.name}}

Payment Information