CE Solutions

Department Activation Form

Please fill out this form to have your department activated with CE Solutions. After completing this form you will receive an email with simple instructions on how to have your members register under your department account.

Fields marked with * are required.

Department Activation Form
Department Name	*
Billing Address	*
City	*
State	*
Zip Code	*
Phone #	*
Fax #	*
Contact Person	*
Accounts Payable Person	*
Accounts Payable Phone #	*
Email Address	*
Pay Method
PO# (If Needed)
Program
Total Number of Members to be Added or Renewed
List Members to be Added or Renewed Example: (JSMITH, MDAVIS, KROGERS)
List Any Members to be Removed