Mitch's Certified Classes

Registration Form

Accredited Academic Training

Instructed by Mitch Prather

Complete the form below and select the "Submit" button at the bottom of the form. A Registration Receipt, with a copy of the information submitted in the form and payment information, will be sent to the Student's Primary Email address, the Company Email address (if listed) and the Payment Method Email address (if applicable).

Note: Items indicated with an asterisk (*) are required.


Student Information:
Company Information:
Payment Method*: