REGISTRATION FORM | Island CERTS Corporation

Class Registration Form

Island CERTS Class Registration Form

Island CERTS reserves the right to cancel any class that does not have a minimum of four people enrolled.

Company name

Contact Person’s Name

Contact Person’s Phone

Job name for billing

PO for billing

Contract Number for billing, if applicable

Student Enrollment

Please list the full names of all attendees for certification.

Student 1: Full Name

Student 1 Training Type

Student 1 Class Type

Student 2: Full Name

Student 2 Training Type

Student 2 Class Type

Student 3: Full Name

Student 3 Training Type

Student 3 Class Type

Student 4: Full Name

Student 4 Training Type

Student 4 Class Type

Student 5: Full Name

Student 5 Training Type

Student 5 Class Type

I confirm all students have a valid medical card and driver's license.

I understand a 24-hour notice is required for cancellations.

I understand classes require a 4-person minimum.

Prefer to submit manually?