The Center for AAC and Autism Credit Card/Purchase Order Form

Credit Card or Purchase Order Request Form
Coupon codes will be provided via email to the person arranging payment for the individual attendees to use during registration. Please allow up to 5 business days to receive the coupon code.

If your company/district is tax exempt, please email a copy to registrations@aacandautism.com

Please also send any questions to registrations@aacandautism.com

PO Address:
Prentke Romich Company (PRC) dba The Center for AAC & Autism
1022 Heyl Road, Wooster, OH 44691
Facility Name/School District
Contact Name (Person Arranging Payment)

First NameLast Name
Contact Email (Person Arranging Payment)
example@example.com
Contact Phone Number (Person Arranging Payment)
Please enter a valid phone number.Format: (000) 000-0000.
Is your company/district tax exempt?
Please forward a copy of your tax exempt form to registrations@aacandautism.com
Select Payment Type
Purchase Order Number (if available)
Training Details
Additional Notes or Comments
Should be Empty:

Credit Card or Purchase Order Request Form