Concrete Technician Re-certification - Section 1072 - 03/04/20, 7:30AM - Chicopee, MA

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Registration Type

Select ONE of the following statements:

I attest that I am employed by a member company (Select Employer below)
I am NOT employed by a member company (Select Non-Member Registration Type above)

Please choose 1 option

Employer

Select member company.

Applicant Signature

Type full name. If registering multiple people then please separate full names with commas then update quantity on next page to match number of people registered.

Consent to Electronic Sig.

Signature indicates that signee is aware of the experience recommendations for this course and is aware of all NETTCP Policies including the Photograph Policy, the Refund Policy, and the Cancellation Policy.

Certification Number

Certification number is required for re-certification courses only.

Section:	1072
Start Date:	03/04/20
End Date:	03/04/20
Location:	Hampton Inn - Chicopee, MA
Hotel Rate:
Course Size:	15 - 30
Comments
Course Meeting Times:	Wednesday - 7:30 a.m. to 3:30 p.m.