|
Food Manager Certification Registration Form
(Please use one form for each registrant.)
Please complete the
form and mail it with a check or money order to:
American Food Safety, 2734 North 5th St, Philadelphia, PA 19133
or you may register by phone or fax with your Visa or Mastercard
by calling (800) 723-3873 or faxing (215) 634-6184.
Class
sizes are limited, so please register early.
| Student
Name |
_______________________________________________ |
| Student
Address |
_______________________________________________ |
| Day-Time
Phone |
(____)
_____________ |
| Business
Name/City |
_______________________________________________ |
| Fax
Number |
(____)
_____________ |
| Course
Language |
English
____ Spanish ____ Chinese ____ |
| Course
Location (City and State) |
_______________________________________________ |
| Course
Date |
___________________ |
| Amount
Enclosed |
___________________ |
| Credit
Card Payment Information |
Visa or Mastercard# __________________________
Expiration
Date __________________________
Signature
__________________________ |
|
Thank you for your registration!
Courses begin at 9
am and end at approximately 4:45 pm (unless otherwise noted on
the schedule). Please bring a photo ID and your Social
Security number with you to the course. Study notes and a
practice exam will be faxed or mailed to you upon receipt of
your registration. Please review the study notes prior to the
course.
American Food Safety, 2734 North 5th St, Philadelphia, PA 19133
Phone: 800-723-3873 Fax: 215-634-6184
|
|
