Registration Form
2006
SAP
Re-Qualification Training
12
DOT Continuing Education Hours
Training Dates & Location
(Please check the date & location of choice)
Dates |
City / State |
Training Site |
| _____March 22, 23 | Atlanta, Georgia | Hampton Inn, Marrietta, Georgia |
| _____April 19, 20 | Columbus, Ohio | Morse Banquet Center |
| _____May 10, 11 | Los Angeles, Calif | TBD |
| _____May 17, 18 | Detroit, Mich | Walsh College, Troy |
| _____June 21, 22 | Washington, DC | Studio Plus, Gaithersberg, MD |
| _____July 19, 20 | Cleveland, Ohio | CID |
| _____August, 16, 17 | St. Louis | Courtyard, Maryville |
| _____September 13, 14 | Dallas, Texas | Hampton Inn, Airport |
| _____October 25, 26 | Columbus, Ohio | Morse Banquet Center |
| _____November 15, 16 | Boston, MA | TBD |
| _____December 6, 7 | Detroit, Mich | Walsh College, Troy |
| _____December 13, 14 | Las Vegas, Nevada | Studio Plus |
Training
Registration Fee: $295.00. Registration: 8:30
a.m.; Training
9:00 a.m. - 4:00 p.m.
Training
includes:
Continental Breakfast and Refreshments each day
12 CEU’s Approved
Education Credit: EAP's, Counselors
& Social Workers
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: (216)
226-2721
or (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.