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First Name *

Last Name *

Email *

Username *

Password *

Confirm Password *

Address *

City *

State *

Country *

Postal Code *

Phone *

Birthdate *

Select payment method: *

Who is filling out this registration form? *

--- AGREEMENT (Student Filling Out Form) --- By putting my initials, I declare that I am the student filling out this registration, and I confirm that the information I put on this form is correct and accurate. (INITIALS) *

What interests you in registering as HLLQP Student? *

When do you intend to finish this course and get your license? *

What is your residency status in Canada? *

Have you gone through bankruptcy or consumer proposal? *

Please provide more detail:

In your credit history, do you have any situation(s) or outstanding debt that may result or trigger what may be considered an "unfavorable standing / status" such as collections and chronic late bill payments? *

Please provide more detail:

Are you currently employed in any of the following: lending money (banks), doctors, nurses, other health care professionals, lawyers, accountants, law enforcement officials, immigration consultants, members of the clergy or government employees? *

Please provide more detail:

Do you have a Criminal Record? *

Please indicate the charge:

Were you convicted?

Are you fully pardoned from the charge/s and conviction/s?

What is the Full Name of your AGA (who invited you to Greatway Financial)? *

---- AGREEMENT (Contracting Concerns) ---- By putting my initials, I agree that if I am not a Canadian Citizen, PR holder or Open Work Permit / Post-Grad Work Permit Holder with at least 6 months validity, or have answered Yes to any of the above questions (credit issues, conflict of interest occupations, criminal record), I may find difficulty in the Contracting step. Financial Career Institute and Greatway Financial does not guarantee my contracting application outcome. (INITIALS) *

AGREEMENT (Cancellation Policy) ----------- By putting my initials, I agree to the Cancellation Policy – Registration fee is non-refundable after 10 days and/or if I attended class, or accessed more than 1 lesson. (INITIALS) *

Agreement acknowledged on: *

City/Municipality *

Province *

--------- Billing Information ----------- Cardholder Name *

Billing Address *

Cardholder Phone *

Cardholder Email *

Initial registration

$

Subsequent fees

$

Promo Code

I accept the terms *

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HLLQP Prep Extension (Québec Resident)