Make sure to copy Registration number after successful submission.
Thank you for payment.
Your payment is verified online.Your payment status showing payment
First Name: *
Last Name: *
Example: Yes, I would like to receive emails from Bates CDC. (You can unsubscribe anytime)
By submitting this form, you are consenting to receive marketing emails from: . You can revoke your consent to receive emails at any time by using the SafeUnsubscribe® link, found at the bottom of every email. Emails are serviced by Constant Contact
1228 S. Jackson St. | Louisville, KY 40203
Phone: (502) 636-0573
All Rights Reserved