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District/Zone Registration for CEP

To request CEP for clubs in your district or zone, please complete the form below:

* Required

Fill out the fields in section below then click the "Add" button. You may add as many Clubs as you need.
*Club Name:
*Club Number:
*District:
*Number of Participants:
*Would you like to download CEP materials for free? Yes   No
*Would you like to purchase CEP materials? Yes   No
If purchasing materials your district will be charged. If you wish individual clubs to purchase their own materials, please have each club complete the Club Registration for the Club Excellence Process.
  Price Quantity Cost
CEP Pro Facilitator Guide with CD US $5.99 $
CEP Pro Participant Workbook US $3.99 $
Total $
*What language would you like your materials in?
When you have completed adding all Clubs, fill out the rest of the form and click the "Submit" button.
Grand Total $

Who is coordinating CEP for your district/zone?

*Name:
*Phone:
*Email:
*Address:
*City:
State/Province:
Zip/Postal Code:
*Country:

Registration Submitted By:

Same as coordinator Yes   No
*Name:
Position/Title:
*Phone:
*Email:

Please Enter This Security Code Below:  
G4CVQG6
You must enter code to Submit this form ->


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