Registration - DLL FLC

We are currently experiencing technical issues with our payment portal through this website. To register for our upcoming FLC 9hr class, please download the FLC 9hr Class Registration Form FLC 9hr Class Registration – Jan 15 & 16, Sonoma and email it to our office: [email protected]
Once received, we will generate an invoice that will allow you to complete payment through our corporate payment portal instead. For any questions, please call 559-451-3411 to speak with one of our FLC 9hr class representatives.

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Type of Attendee

Price

Quantity

Total

Farm Labor Contractor

$300

Quantity

Total

Non Farm Labor Contractor

$300

Quantity

Total

Final Total

Final Total Amount

FLC Information

FLC License Number

If new FLC please write pending

Business Information

Business/Individual Name *

If the business is an Individual/Partnership/Sole Proprietor/Doing Business As (DBA) the information you enter as your Business/Individual Name must read from your driver's license or if the business is a Corporation/LLC the information you enter as your Business/Individual Name must read like your official documents.

Email *

Phone *

Address *

Address

Address

Address

City

City

State/Province

State/Province

Zip/Postal

Zip/Postal

FLC Attendee 1

FLC Attendee 1

Name

First

Last

Last

Class Date & Language Preference *

Location Details:
DLL Insurance Agency
1843 E Fir Ave Ste 102
Fresno, CA 93720

FLC Attendee 2

FLC Attendee 2

Name

First

Last

Last

Class Date & Language Preference *

Location Details:
DLL Insurance Agency
1843 E Fir Ave Ste 102
Fresno, CA 93720

FLC Attendee 3

FLC Attendee 3

Name

First

Last

Last

Class Date & Language Preference *

Location Details:
DLL Insurance Agency
1843 E Fir Ave Ste 102
Fresno, CA 93720

FLC Attendee 4

FLC Attendee 4

Name

First

Last

Last

Class Date & Language Preference *

Location Details:
DLL Insurance Agency
1843 E Fir Ave Ste 102
Fresno, CA 93720

FLC Attendee 5

FLC Attendee 5

Name

First

Last

Last

Class Date & Language Preference *

Location Details:
DLL Insurance Agency
1843 E Fir Ave Ste 102
Fresno, CA 93720

FLC Attendee 6

FLC Attendee 6

Name

First

Last

Last

Class Date & Language Preference *

Location Details:
DLL Insurance Agency
1843 E Fir Ave Ste 102
Fresno, CA 93720

Non FLC Attendee 1

Non FLC Attendee 1

Name

First

Last

Last

Class Date & Language Preference *

Location Details:
DLL Insurance Agency
1843 E Fir Ave Ste 102
Fresno, CA 93720

Non FLC Attendee 2

Non FLC Attendee 2

Name

First

Last

Last

Class Date & Language Preference *

Location Details:
DLL Insurance Agency
1843 E Fir Ave Ste 102
Fresno, CA 93720

Non FLC Attendee 3

Non FLC Attendee 3

Name

First

Last

Last

Class Date & Language Preference *

Location Details:
DLL Insurance Agency
1843 E Fir Ave Ste 102
Fresno, CA 93720

Non FLC Attendee 4

Non FLC Attendee 4

Name

First

Last

Last

Class Date & Language Preference *

Location Details:
DLL Insurance Agency
1843 E Fir Ave Ste 102
Fresno, CA 93720

Non FLC Attendee 5

Non FLC Attendee 5

Name

First

Last

Last

Class Date & Language Preference *

Location Details:
DLL Insurance Agency
1843 E Fir Ave Ste 102
Fresno, CA 93720

Non FLC Attendee 6

Non FLC Attendee 6

Name

First

Last

Last

Class Date & Language Preference *

Location Details:
DLL Insurance Agency
1843 E Fir Ave Ste 102
Fresno, CA 93720

If you have any questions please contact our FLC Department at (559) 721-4715.

*Fees are nonrefundable, but credit is valid within the year.*

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