Registration Form

Please fill out the below secure form to complete your registration. If you would prefer to fax or mail in your registration form manually, please click here to download the form.


































    Please share any related experience




    Please read the following:


    I understand that the Windshield Repair Training Program provided by Fix-a-Crack for which I am applying includes classroom and on-the-job instruction together with written training materials and tools all of which are included in the full tuition fee. I understand that 100% of the fees that I may earn as a Windshield Repair Technician are mine to keep and that no portion will be paid to Fix-a-Crack. No one employed by or associated with Fix-a-Crack has implied that I will be provided with or guaranteed employment if I successfully complete this course. I fully understand and accept this.



    AgreeDisagree


    Credit Card Information: (Secure Server Page)














    A $500.00 deposit is required with this form and will be applied against your credit card. You have read this and agree.


    Agree

    * Please Note - Due to limited class sizes we will not process any registrations and reserve a seat without the $500 initial deposit.

    Deposit Policy: Course Fee Deposits are refundable less $75.00 admin fee up to 10 business days prior to start of the course date. Deposits and/or full payments made for the training are non-refundable thereafter but transferable to the next upcoming course date. Students are only allowed one course date change if need be due to the limited size of the classes.