Professional Grooming Credentialing Institutions

This payment form is to be used either/or full courses or video library to be approved by the PGC programs.

Institution Name *
Contact First and Last Name *
Position Held
Street (Mailing) Address *
City *
State/Province *
Zip/Postal Code *
Telephone: *
Email Address: *
One (1) Course Price

Clear Selection
Two (2) Course Price

Clear Selection
Each additional course above two is $500 each. Please fill in the appropriate price below:
Please place any comments or notes here:

Payment Information

Amount to Charge :
Payment Method:

Fields marked with * are required.

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