Class Registration

Section A. Student Information
* Required. If an item is "Not Applicable" type: N/A.

Select number of Students you are enrolling (up to 5): 1 2 3 4 5

1. Student One
*1a. Name:  
*1b. Email: (e.g.: name@aol.com)  
*1c. Company/Agency Name:
*1d. Address (Home or Office):  
*1e. City:  
*1f. State:  
*1g. Zip:  
*1h. Phone #: (include AC)  


2. Student Two
*2a. Name:  
*2b. Email: (e.g.: name@aol.com)  
*2c. Company/Agency Name:
*2d. Address (Home or Office):  
*2e. City:  
*2f. State:  
*2g. Zip:  
*2h. Phone #: (include AC)  


3. Student Three
*3a. Name:  
*3b. Email: (e.g.: name@aol.com)  
*3c. Company/Agency Name:  
*3d. Address (Home or Office):  
*3e. City:  
*3f. State:  
*3g. Zip:  
*3h. Phone #: (include AC)  


4. Student Four
*4a. Name:  
*4b. Email: (e.g.: name@aol.com)  
*4c. Company/Agency Name:  
*4d. Address (Home or Office):  
*4e. City:  
*4f. State:  
*4g. Zip:  
*4h. Phone #: (include AC)  


5. Student Five
*5a. Name:  
*5b. Email: (e.g.: name@aol.com)  
*5c. Company/Agency Name:  
*5d. Address (Home or Office):  
*5e. City:  
*5f. State:  
*5g. Zip:  
*5h. Phone #: (include AC)  

*1. Select class:
       (Classes held at 24662 Redlands Blvd, Loma Linda, CA 92354 unless otherwise noted.)


Select Class Start Date & Location 24 Feb - 3-day Lead Worker - Loma Linda $0.00 27 Feb - 1-day Mold Awareness - Loma Linda $195.00 01 Mar - 5-Day Lead Inspector/Risk Assessor - Loma Linda $695.00 09 Mar - 1-day Lead General REFRESHER - Fresno $185.00 12 Mar - 2-day Lead Supervisor - Loma Linda $295.00 19 Mar - 1-day Lead Sampling Technician - Loma Linda $190.00 28 Mar - 1-day EPA Renovation Repair & Painting - Loma Linda $245.00

*2. Type Verification Code Shown:       <<< Verification Code

3. Payment is required. You can pay by Credit Card on the next page. Please note that your registration is not complete until payment has been received. If you wish to pay by a method other than a Credit Card, complete this registration and then please call (800) 648-5323.

When you are ready to proceed, hit REGISTER once. Thanks!