REGISTRATION FORM Chemical Feed Pump Repair 0.2 CEU's
Note: This training is the same day as the Annual Training & Trade Show (formally the Clam Bake). All registrants will be provided with meal tickets to attend this event.
Cost: The cost of this training is $70.00 for all attendees. Lunch is included. Payment must be received by Friday, July 23, 2010 Cancellation Policy: If you cannot attend you must contact Leanne Monaghan at 508-946-2225 or via email at education@pcwwa.org by 9:00 Friday July 23, 2010. All no shows who do not contact PCWWA prior to this deadline will be responsible for payment in full.
Please note that this form must be complete to register for the class.
PLEASE ! When entering your information below please enter it in a proper format. For example John J. Doe not john doe or JOHN DOE etc.
Last Name Only
Name (As you want your name printed on Certificate) (For example: "John J. Doe")
Job Title / Position
Business Name
Business Address
City/Town
State
Zip
Valid Email Address
Phone
Are you a member of PCWWA? Yes No
PLEASE CLICK SUBMIT ONLY ONCE
AND WAIT FOR CONFIRMATION PAGE (This process could take up to 1 minute) If you do not receive confirmation your are NOT registered
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