Questions about getting a COVID-19 vaccine? See the latest on our blog

Registration

Please fill out the following form to register for the PacificSource Medicare Agent Training below:

Medicare Producer Reappointment Training
Best Western Plus Mill Creek Inn
3125 Ryan Dr. SE, Salem 97301
8/20/2021 - 12:00 pm

Number of Attendees:

Attendee 1

Agency

First Name

Last Name

PM #

Phone Number

Email Address

Attendee 2

Agency

First Name

Last Name

PM #

Phone Number

Email Address

Attendee 3

Agency

First Name

Last Name

PM #

Phone Number

Email Address