Distance Learning Order Form

To order Distance Learning courses from CAMLT, complete the registration form below and mail it with your payment by check or Visa/MasterCard to: 

CAMLT Distance Learning 
1895 Mowry Ave., Ste. 112 
Fremont CA 94538 
510-792-4441 
Fax: 510-792-3045

The fee for Distance Learning courses is $12 per CE hour for CAMLT members and $15 per CE hour for non-members.  For example, the member fee for a one-hour program is $12, while the member fee for a three- (3) hour program is $36.  The non-member fee for a one-hour program is $15, while the non-member fee for a three- (3) hour program is $45.  Become a member and SAVE!  To order, print and complete the form below and send it with your payment to CAMLT at the address above. You may fax your order if you are paying by MasterCard or Visa.

After completing the Distance Learning course, send the complete Answer Sheet(s) along with the evaluation form(s) to CAMLT at the address/fax # listed above. When you have successfully completed a Distance Learning course, a certificate will be mailed to you. Successful completion of the course is defined as receiving a score of 70% or higher on the Review Questions.

Notification of Distance Learning Deadline
DON'T PUT YOUR LICENSE IN JEOPARDY!

This is a reminder that all the continuing education units required to renew your license must be earned no later than the expiration date printed on your license.  If some of your units are made up of Distance Learning Courses, please allow yourself enough time to retake the test in the event you do not pass on the first attempt.  CAMLT urges you to earn your CE units early!
 

CAMLT Distance Learning Order Form

Name_________________________________________________________ 
Address_______________________________________________________ 
City_________________________________State_____Zip______________
Telephone (H)_______________________(W)________________________ 
Email _________________________________________________________
CA DHS License or Certification # __________________________________
Courses Selected _______________________________________________ 
_____________________________________________________________ 
Signature____________________________________________________ 
                Signature required for all registrants

Check one: (   ) Member   (   ) Non-Member
Fee: (member: $12/CE unit) (non-member: $15/CE unit)

Method of Payment:
______Check  ___ Visa ___ MasterCard 
Card # ________________________________________
Exp. Date_______________