Membership Registration

Registration Summary
Conference
Date / Location
Price
1 Year Membership
$1,499.00
PDO Thread Lift Training I & II Nashville, TN
$2,299.00
Dermatology Procedures for the Primary Care Practice Fort Lauderdale, FL
$1,099.00
PDO Thread Lift Training I & II Empire-Virtual-Training
$999.00
Anti-Aging (Modules I & II) Chicago, IL
$1,199.00
Botulinum Toxin Training Riverside, CA
$1,199.00
Advanced PDO Threads Orlando, FL
$3,299.00
Master Injector Series I Atlanta, GA
$3,199.00
Complete Dermal Filler Training Chicago, IL
$2,099.00
remove all
Total Amount Due:
$16,891.00
vendor code (if any)

Registration Buyer
   
First Name*
Last Name*
Medical Title*
Email Address: *
Telephone: *
Are you a practice owner?*
Name of Account Rep who guided you, if any:

State License #:


Payment - Empire-Split-Pay™
   
Credit Card: *
Credit Card Number: *
Expiration Date: *
CVV*
Amount to charge in this credit card: *$
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Payment - 2nd Credit Card
   
2nd Credit Card: *
2nd Credit Card Number: *
Expiration Date: *
CCV*
Amount to charge in 2nd credit card: *$
  


Billing Information: (address where you receive your monthly credit card statement)
   
Country: *
Address: *
Address:
City: *
State: *
Zip Code: *

  By clicking "Pay Now", I acknowledge that I have read and agree with the Empire Medical Training terms of service, privacy policy, and cookie policy.
Amount to be charged: $16,891.00


NEED FINANCING?

No Payments + No Interest if paid in full in 6 months using: