Registration To register for the Certificate or a specific class, please fill out the application form, below. Enrollment Application Contact InformationName* First Last Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email* Phone*Emergency Contact Name* First Last Emergency Contact Relationship*Emergency Contact Phone*General ApplicationReferred By First Last Which Individual Class are you enrolling in?*What are you enrolling in?*Tell us about yourselfWhat is your current occupation?How long have you worked in this occupation?What is your highest level of education?Please be aware there is no requirement that you have a high school diploma or GED to participate in our program. We simply would like to know something about the background of our participants.Please share with us what prompted your interest in retail:*Please share with us your goals for participating in this program. Please be as specific as possible.*The Center for Retail Excellence does not discriminate on the basis of race, color, religion (creed), gender, gender expression, age, national origin (ancestry), disability, marital status, sexual orientation, or military status, in any of its activities or operations.CommentsThis field is for validation purposes and should be left unchanged.