Water Conservation Ass.docx
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WaterConservationAss
RegistrationForm
WaterConservationCEUTrainingCourse$100.00
48HOURRUSHORDERPROCESSINGFEEADDITIONAL$50.00
StartandFinishdates:
___________________________Youwillhave90daysfromthisdateinordertocompletethiscourse
Name________________________________Signature__________________________
Ihavereadandunderstoodthedisclaimernoticeonpage2.DigitallysignXXX
Address:
__________________________________________________________
City______________________________State_____________Zip____________
Email________________________________Fax(____)___________________
Phone:
Home(____)__________________Work(____)_______________________
OperatorID#____________________________ExpDate_________________
Pleasecircle/checkwhichcertificationyouareapplyingthecourseCEU’s/PDH’s.
WaterTreatment_____Distribution_____
Other________________________________
Yourcertificatewillbemailedtoyouinabouttwoweeks.
TechnicalLearningCollege
POBox420,PaysonAZ85547-0420
(928)468-0665Fax(928)272-0747Back-upFax(928)468-0675
TollFree(866)557-1746
info@
DiscovercardCCVcodeoncard_________
AmericanExpress
VisaorMasterCard#_______________________________________Exp.Date_________
Ifyou’vepaidontheInternet,writeyourCustomer#____________
Referral’sName_____________________________________________________
Invoiceme,PO#________________________________
DISCLAIMERNOTICE
IunderstandthatitismyresponsibilitytoensurethatthisCEUcourseiseitherapprovedoracceptedinmyStateforCEUcredit.IunderstandStatelawsandruleschangeonafrequentbasisandIbelievethiscourseiscurrentlyacceptedinmyStateforCEUorcontacthourcredit,ifitisnot,IwillnotholdTechnicalLearningCollegeresponsible.IalsounderstandthatthistypeofstudyprogramdealswithdangerousconditionsandthatIwillnotholdTechnicalLearningCollege,TechnicalLearningConsultants,Inc.(TLC)liableforanyerrorsoromissionsoradvicecontainedinthisCEUeducationtrainingcourseorforanyviolationorinjurycausedbythisCEUeducationtrainingcoursematerial.IwillcallorcontactTLCifIneedhelporassistanceanddouble-checktoensuremyregistrationpageandassignmenthasbeenreceivedandgraded.
StateApprovalListingLink,checktoseeifyourStateacceptsorhaspre-approvedthiscourse.NotallStatesarelisted.Notallcoursesarelisted.IfthecourseisnotacceptedforCEUcredit,wewillgiveyouthecoursefreeifyouaskyourStatetoacceptitforcredit.
ProfessionalEngineers;MoststateswillacceptourcoursesforcreditbutwedonotofficiallylisttheStatesorAgencies.PleasecheckyourStateforapproval.
StateApprovalListingURL…
YoucanobtainaprintedversionofthecoursemanualfromTLCforanadditional$49.95plusshippingcharges.
AFFIDAVITOFEXAMCOMPLETION
IaffirmthatIpersonallycompletedtheentiretextofthecourse.IalsoaffirmthatIcompletedtheexamwithoutassistancefromanyoutsidesource.Iunderstandthatitismyresponsibilitytofileormaintainmycertificateofcompletionasrequiredbythestateorbythedesignationorganization.
GradingInformation
Inordertomaintaintheintegrityofourcourseswedonotdistributetestscores,percentagesorquestionsmissed.Ourexamsarebaseduponpass/failcriteriawiththebenchmarkforsuccessfulcompletionsetat70%.Onceyoupasstheexam,yourrecordwillreflectasuccessfulcompletionandacertificatewillbeissuedtoyou.
Forsecuritypurposes,pleasefaxore-mailacopyofyourdriver’slicenseandalwayscallustoconfirmwe’vereceivedyourassignmentandtoconfirmyouridentity.
Thankyou……
WaterConservationAnswerSheet
Name____________________________________Telephone______________________
Pleasecircle,bold,underlineorXoneansweronly
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