SCAFFOLD TRAINING INSTITUTE

Houston Training Center 311 East Walker Street League City, TX 77573

281-332-1613 Fax: 281-316-2030

www.scaffoldtraining.com


CLASS REGISTRATION FORM



Note: Payment prior to start of class is required, see below.


DATE OF CLASS ATTENDING:


COMPANY NAME:

 

BILLING ADDRESS:

 

CITY, STATE, ZIP:

 

PHONE #:

 

ATTENDEES CELL PHONE #:


PAYMENT INFORMATION: (Payment in advance expected unless special

arrangements are made.)

WILL BRING CHECK:

CREDIT CARD # & Exp.:

Will call prior to class to request special payment arrangements:


Names of Attendees for MODULE 1 "COMPETENT PERSON” One day:($150 each).


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Names of Attendees for THREE DAY “TRAIN-THE-TRAINER” COURSE:

($750 each.)


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Names of Attendees for FOUR DAY (32 hour) COURSE: ($1000 each).


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Names of Attendees for FIVE DAY (40 hour) COURSE: ($1250 each).


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Number of Additional Manuals for Trainers ($40.each):


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(PLEASE RETURN VIA FAX OR EMAIL AT YOUR EARLIEST CONVENIENCE: 281-

316-2030 or deborah@scaffoldtraining.com)