Registration Form
2010
Dot Substance Abuse Professional 2 Day Qualification / Requalification Training
&
The IC&RC DOT/SAP Written Examination
(Please check the date & location of choice.)
Dates |
City / State |
Training Site |
| April 14, 15, 16 | Detroit, Mich. | Walsh College, Troy |
| May 12, 13, 14 | Cleveland, Ohio | CID Lakewood |
| June 9, 10, 11 | Washington, DC | To Be Determined |
| July 14, 15, 16 | St. Louis, Mo. | To Be Determined |
| August 18, 19, 20 | Columbus, Ohio | Morse Banquet Center |
| September 22, 23, 24 | Atlanta, Georgia | To Be Determine |
| October 6, 7, 8 | Cleveland, Ohio | CID Lakewood |
| November 17, 18, 19 | Detroit, Mich. | Walsh College, Troy |
| December 8, 9, 10 | Las Vegas, Nevada | Sam's Town |
Note: The two day training can be used as a refresher course for the individual who is already a qualified SAP as it meets the DOT/SAP re-qualification criteria for 12 contact hours.
Training
Registration Fee: $295.00. Registration: 8:30
a.m.; Training
9:00 a.m. - 4:00 p.m.
Training
includes:
Training Manual and Study Guide for IC&RC
DOT/SAP Qualification
Test
Continental Breakfast and Refreshments each day
12 CEU’s Approved
Education Credit: EAP's, Counselors
& Social Workers
Test
Registration Fee: $125.00 · Test Dates in Bold
Registration: 8:30 a.m.; Testing: 9:00 a.m.
- 11:00 a.m. (2 hour limit)
*Note: Michigan Professionals must register for test through MCBAP. Call 517 347-0891 to register.
Name:
_______________________________________________Phone #:________________
Agency:
______________________________________________________________________
Address:
_________________________________________ Email:______________________
City:
______________________________________ State: _________ Zip:________________
Training
Fee: $295.00 ____ Testing Fee: $125.00 _____Total Amount Enclosed: ________
________________________________________________________
/ ___________________
Visa/MasterCard
Number
Expiration Date
Signature: ____________________________________________________________________
Enclose
the registration form with check or Visa/MasterCard number payable to:
Professional
Training Center, Inc.
P.O.
Box 295 · Marysville, Michigan
48040
Phone:
(810) 388-0200
Fax:
(810) 388-1342
email
Tom Foley: tfa@tir.com
Confirmation
Letters with specific location and directions will be sent upon receipt of
registration.