BuildASALESPERSON™ Registration

Company Information

*Company Name:      Dealer Account #:

*Address:      *City:     State:     Zip:

*Manager Name:     *Phone #:     Cell #:

*Manager's e-mail Address: Fax #:

*Territory Manager:

* Indicates REQUIRED field.

Student Information

Student #1:

First Name:     Last Name:

E-mail Address (REQUIRED):

Phone: Cell:

Class: SELECT CLASS Jan 30 - Feb 24 Mar 19 - April 13 April 23 - May 18 June 4 - June 29 Aug 6 - Aug 31 Sep 10 - Oct 5 Oct 15 - Nov 9 Nov 26 - Dec 21

Are you a registered user of our LMS? Yes No

Student #2:

First Name:     Last Name:

E-mail Address (REQUIRED):

Phone: Cell:

Class: SELECT CLASS Jan 30 - Feb 24 Mar 19 - April 13 April 23 - May 18 June 4 - June 29 Aug 6 - Aug 31 Sep 10 - Oct 5 Oct 15 - Nov 9 Nov 26 - Dec 21

Are you a registered user of our LMS? Yes No

Student #3:

First Name:     Last Name:

E-mail Address (REQUIRED):

Phone: Cell:

Class: SELECT CLASS Jan 30 - Feb 24 Mar 19 - April 13 April 23 - May 18 June 4 - June 29 Aug 6 - Aug 31 Sep 10 - Oct 5 Oct 15 - Nov 9 Nov 26 - Dec 21

Are you a registered user of our LMS? Yes No

Student #4:

First Name:     Last Name:

E-mail Address (REQUIRED):

Phone: Cell:

Class: SELECT CLASS Jan 30 - Feb 24 Mar 19 - April 13 April 23 - May 18 June 4 - June 29 Aug 6 - Aug 31 Sep 10 - Oct 5 Oct 15 - Nov 9 Nov 26 - Dec 21

Are you a registered user of our LMS? Yes No

Method of Payment

Bill My Lennox Dealer Account   Credit Card   For credit card payment call 800.654.3283, Option 2

Dealer Acct#:    Check here if you are a Premier Dealer.

Please enter the code below.

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