Recertification Registration

You're registering for: Assembly/Disassembly Director

Online recertification. Please complete the details below. You'll be taken to our secure Stripe checkout to pay.

Student Contact Information

First name *

Last name *

Attendee email *

Confirm email *

Attendee mobile phone *

Attendee work phone *

Certification number *

Expiration date *

Company

Company name *

Street (1) *

Street (2)

City *

State *

Zip code *

Country *

Point of Contact

Point of contact email *

Confirm email *

Home Address

This is the address where the materials for the online class will be shipped. If they are attending an in-person class please provide home address.

Street (1) *

Street (2)

City *

State *

Zip code *

Country *

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