Choose one of the following options:

Backflow Assembly Tester Training          $600

Please provide the following attendee information:

Student Name
Student Name
Student Name
Student Name
Student Name
Company
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
FAX
E-mail

                   Choose one of the following event options:

 

2009 BAT CLASSES

 

January 15 - 30, 2009        (BAT 40 Hour night class 5pm -  9pm) 

February 23 - 27, 2009      (BAT 5 day class 8:30am - 5:30pm)

March 12 – 27, 2009         (BAT 40 Hour night class 5pm - 9pm)

April 06 – 10, 2009            (BAT 5 day class 8:30am - 5:30pm)

May 07 - 22, 2009             (BAT 40 Hour night class 5pm - 9pm) 

July 13 - 17, 2009              (BAT 5 day class 8:30am - 5:30pm)

August 06 - 21, 2009          (BAT 40 Hour night class 5pm - 9pm) 

September 14 - 18, 2009    (BAT 5 day class 8:30am - 5:30pm)

October 08 - 23, 2009        (BAT 40 Hour night class 5pm - 9pm) 

November 16 - 20, 2009    (BAT 5 day class 8:30am - 5:30pm)

 

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CCENV NOW REQUIRES A FORM OF PAYMENT BE DECLARED BEFORE WORK IS STARTED

          Please provide the following Payment information:

If you will be paying by check please click the check box and remit payment to:

Cross Connection Environmental

1802 S Carson Street Suite 212-2783

Carson City, Nevada 89701

Students will not be fully registered until payment is received.

Card Type	Visa Master Card Discover American Express
Credit Card Number
Expiration Date
Name of Cardholder
Billing Address
City State Zip code
Number of Students
Email Address for Receipt

Credit card information is recorded to a secure server.   Information not transmitted over internet.

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