MA Food Allergen Registration

First Name*

Middle Initial

Your Middle Initial is used as a unique identifier.

Last Name*

Address*

Street Address City State ZIP Code

Phone*

User Account

To access the course, you need to create an account. Take note of your username and password as you will be required to login after successful completion of registration. Please Note: An email will be sent with your registration confirmation and login details.

Username*

Email

Password*

Enter Password Confirm Password

Please note your password, Berkshire AHEC has no access to this field. Password is needed to log into the system to complete the course or retrieve a copy of your certificate at a later time.

Payment

When you click Register and Pay, you will be redirected to our PayPal account page. Payment can be made with a credit card or PayPal account.

MA Food Allergen Training

Price: $10.00

Total

$0.00