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800-723-3873

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