Restoration Industry Association -- Educational Programs and Events Registration

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Educational Programs and Events

Certified Mold Professional Course

November 14-16, 2006 — Kalamazoo, MI

CECs: RIA—3 credits; IICRC—1 mold, 2 cleaning/restoration; NADCA—4 credits

REGISTRATION FORM

If you do not receive a confirmation for your purchase from RIA by Wednesday, September 20th, please contact the RIA office at (443) 878-1000. Thank you.

ATTENDEE INFORMATION

* = REQUIRED FIELD

Company: *

Address:

City:

State:

Zip:

Phone:

Fax:

Contact Email: *

Attendee(s):
Print name exactly as it is to appear on certificate.

Please indicate Pre-requisite Courses and Dates Taken:

Mold Remediation Technician Course

Date Taken:

Mold Remediation Project Supervisor Course

Date Taken:

CLASS DATES AND LOCATIONS

Select which class session you will be attending: *

November 14-16, 2006 Kalamazoo, MI
Wonder Makers Environmental
2117 Lane Blvd.
Kalamazoo, MI 49001
Time: 8:30am–4:30pm

PAYMENT

Cost: $750 per person for RIA members
Price includes testing and certification fees.

Registration will not be processed without payment.
To pay for registration by check, please use downloadable form and mail to RIA.

Please charge my American Express MasterCard Visa

for the total of $

Cardholder name

Credit card number

Expiration Date

Month: Year:

SUBMIT

You may also FAX this form to:

(443) 878-1010

or MAIL this form (with payment) to:

RIA International
9810 Patuxent Woods Dr., Suite K
Columbia MD 21046-1595