Selling/Marketing to Older Adult Buyers
and Buyers with Disabilities


1-  Please complete the Course Registration form, below. Once complete, click submit.  
Confirmations of registration are sent via email within three days of receipt.  

  Registration is not complete until payment is received.

2-  Please use the 'BUY NOW' button provided at the bottom of this page to pay via credit card through PayPal.  Checks or money orders are accepted by mail.  Send this form of payment to: 

EmpowerAbility LLC
107 Syracuse Drive
Newark, Delaware 19713
First Name: *
Last Name: *
Street Address: *
Street Address 2:
City: *
State: *
zip code: *
Home Phone: *
Work Phone:
Email: *
Copyright Statement: I will respect the copyright of written materials by EmpowerAbility LLC and Debra Young. I will not copy, forward or transfer the materials provided to me to anyone or onto other document unless written permission is provided directly from Debra Young to me directly for a specific purpose. NOTE: Your electronic (typed) signature on this document constitutes your legal signature in accordance with 21 CFR Part 11: Electronic Records; Electronic Signatures Act.: *