HomeSafe Environmental Training
Register Here for Onsite (classroom) Classes

To register for our "on-line" CEG class, go to: HomeSafe Online

Please complete the form below. This registration method holds space for 72 hours. After that, all fees must be paid in full to hold your seat. We accept Credit Cards, Business Checks, Money Orders, & Purchase Orders. 

For Credit Cards:
Comnplete this form then use our Secure Checkout powered by Authorize Net

For Checks/Money Orders:
Complete each section of the form, then send Check or M.O. (U.S. Funds) payable to HomeSafe Environmental to:

HomeSafe Environmental, Inc.
Attn: Training
24662 Redlands Blvd
Loma Linda, CA 92354
For Purchase Orders:
To use a Purchase Order, complete all sections of the form below AND type the P.O. # in the "Student Name" text box.  Please call  1-800-648-5323 to confirm.

(Note: Students will not be admitted unless payment arrangements are complete.)
An entry for each numbered item is REQUIRED.
If "Not Applicable" type: N/A.

Section A. Company Contact (Person responsible for registration)

    1. Name:  
    2. Email address: (e.g.: name@aol.com)  
    3. Company/Agency Name:
    4. Address:  
    5. City:  
    6. State:  
    7. Zip:  
    8. Business phone #: (include AC)  
    9. Business fax #: ( include AC; if none put N/A)  
Section B. Course Info
    10. What course(s) are you registering for? (Check all that apply)

    Lead Worker (English) (W3)
    Lead Worker (Spanish) (W3Sp)
    Lead Supervisor / Monitor (English) (SSPM)
    Lead Sampling Technician (ST)
    Lead Inspector / Assessor  (IA)
    Lead General Refresher  (CEG)
    Lead Worker Refresher  (CEW)
    Lead Worker Refresher (Spanish) (CEWSp)
    Lead Awareness (LAW)
    Mold Awareness (MAW)
    Asbestos Worker Refresher  (AWR)
    Asbestos Supervisor Refresher  (ASR)

    11. What is the first course start date? (i.e. June 6)  
    Not sure? Check Schedule.  Hit browser "Back" button to return.

Section C. Student Info
12. How many student's are you registering? (1,2,3 etc.)  
    13. List student's name(s): (First, MI, Last)
    If more than one student, list additional names on separate lines.
Section D. Payment
14. How do you intend to pay? (Select one)
 Credit Card - Make Payment Now
 Check  - Mail to above address (U.S. Funds).
 P.O.  - Fax copy to (909) 796-2155

15. Total amount due:(i.e. $295.00)  

An entry for each numbered item is REQUIRED.
If "Not Applicable" type: N/A.

Credit Cards

REMEMBER ... your registration is not complete and a seat will not be confirmed until we have received full payment.

    When you are finished, hit the SEND button once. Thanks!

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