Theft Talk Online Services

Registration

Purchase and Launch your course. Once registered, you will have access to launch courses in the system. Required items are marked with an asterisk (*).

* First Name / Middle Name / * Last Name

(As you would like it to appear on your certificate)

* Address

* City / State / Postal Code

* Email Address:

* Username (case-sensitive):

Note: Please write these down in a safe spot, you will need them to log back in.

* Password (case-sensitive):

* Confirm Password (case-sensitive):

Employment/School

Phone

Additional Information

Age

Gender

Date of Birth (mm/dd/yyyy)

What were you charged with?

Did you do it? (Answer is strictly confidential - For statistical use only)

Security Question
(Please provide the last 4 digits of your SS# or Your Date of Birth or Your Pets Name.)

If someone else is paying, we need to connect that name to you:

Payer's Full Name

Referrer Information

If you provide the Referring Person�s email address they will be notified by email automatically of your enrollment in the course as well as your completion. Upon completion of the program you will be issued a certificate of completion which you can print out right away. If you need a hard copy mailed/faxed/emailed to you or your referring party please notify us of that need upon completion. (Note: You can provide additional information later if needed � by selecting *My courses and Information and selecting �Account Information�

Referring Person's Name

* Referring Agency (Name of Court, Probation Dept, etc)

Your Case Number

Referring Person's Email Address

Referring Person's Fax Number

Referring Person's Address

City / State / Postal Code