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EXACT E-learning Portal Registration
Practice Name
*
Practice ID in EXACT
*
Your Team will be added to our E-learning Portal as a ‘Learning Group'.
We will also set up an E-learning Team Leader.
The Team Leader can assign topics and track e-learning progress
First Name (E-learning Team Leader)
*
Last Name (E-Learning Team Leader)
*
Email
*
How did you hear about the EXACT E-Learning Portal?
*
Register your Team
Note: The email address must be unique for each person you wish to register.
First Name
Last Name
Email address**
E-learner 1
First Name
Last Name
Email address**
E-learner 2
First Name
Last Name
Email address**
E-learner 3
First Name
Last Name
Email address**
E-learner 4
First Name
Last Name
Email address**
E-learner 5
First Name
Last Name
Email address**
E-learner 6
First Name
Last Name
Email address**
E-learner 7
First Name
Last Name
Email address**
E-learner 8
First Name
Last Name
Email address**
E-learner 9
First Name
Last Name
Email address**
E-learner 10
First Name
Last Name
Email address**
Once submitted, you will be contacted by a training consultant with confirmation of your registration in 3-5 business days.
Please submit two registration forms if you wish to register more than 10 people
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