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Enter your name in the format (First Name)(Middle Name)(Last Name)
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Enter your Email address. Check to see that the email address has been correctly entered.
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Enter your Street Address that is on file with the credit card issuer. If your current residential address is different from the one on file with the credit card issuer, provide the current address in the message box that can be found before you hit the SUBMIT button.
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Enter your City Name here.
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Enter your State or Province name. Use the 2 letter abbreviations for States and Provinces in Canada and U.S.A. (Example: IL for Illinois)
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Enter the Zip or Postal Code.
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Choose the month in which you want to attend our Remedial Math prep course.
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Choose COURSE CENTER where you would like to attend the MLIC training course. If the course is offered more than once each month in any center (such as New York or Chicago), please indicate your preferred week in the Message box before the SUBMIT button. MLIC will consider your request but reserves the right to register you in any of the available dates during the month specified.
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Choose the Prep course in which you are registering. In Canada, GST/HST will apply on the course fee indicated.
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Type in your undergraduate or baccalaureate major area of study and the year of graduation. If you are still in high school, indicate your status such as 'grade 11'.
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Choose the method of payment from the drop-down list. We can accept certified or bankers'checks or money orders as well in USA. For other countries, you can pay with major credit cards indicated in the list or with wire-transfer. Please contact us for options of payment other than using credit cards or debit cards bearing Visa, Amex, Discover, or Mastercard logos. For Wire Transfer, contact us so that we can provide banking information. If you want to pay with certified check or money order, contact us for further guidance.
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Enter your complete 16-digit Visa/Mastercard/Discover Card number here. If you are using American Express, enter the 15 digit card number found on the front of the card. For Visa/Mastercard/Discover, use the format xxxx-xxxx-xxxx-xxxx and for Amex, use the format xxxx-xxxxxx-xxxxx
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Enter the card expiration date in mmyy format
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Enter the 3-digit code found on the back of the Visa/Mastercard/Discover Card in the signature panel. If you are using Amex card. enter the 4-digit code found on the front of the card and above the last 5 digits of the card number. If you are using Amex Business card, the security code may be on the signature panel of the card.
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Enter the name of the cardholder as it appears on the front of the card.
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Enter your telephone number here. If you are in the USA or Canada, enter the area code followed by your telephone number. If you are in other countries, enter your country code followed by your telphone number including area code.
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Enter any special requests or messages here. You can provide alternate email addresses here or provide the current residential address if it is different from the one on file with the credit card company. If the Cardholder paying for this course is different from the registering person, enter the cardholder's full address and the relationship of the cardholder to you. If you have a Corporate discount or other code, you should enter it here as well.
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You must agree to the terms of sale by checking the box in this field. We cannot process your order unless you agree to these conditions. If the credit card is issued in the name of a person other than the registering person, then the person in whose name the card is registered must be entered in the field for CARDHOLDER Name. After you hit the SUBMIT REGISTRATION button, please read the message you will receive and check whether there are any missing information fields. If the message indicates MISSING INFORMATION, please hit the BACK button on the browser and complete the missing information as indicated. If your submission was successful, you will receive SUCCESS message.
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