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Focus Carolina-15 Registration Form

Thank you for deciding to join the Focus Carolina-15 program. Please fill out the form below to begin the registration process.

Identifying Information

Address and Phone

Payments and Discounts

Please indicate the amount of your payment by selecting one of the radio buttons below. If you are eligible for any discounts, you must also select one or two of the check boxes below the payment amounts.

Note that the full cost of the program is $1,995, but if you pay in full with credit card the price is reduced to $1,895.
Upon clicking submit, you will be redirected to the website for secure payment processing. Additionally will email you a receipt of payment.