HAZWOPER TRAINING APPLICATION 2010

Directions: Please either complete this application and submit it on-line; or print it, fill it in, and mail or fax to us:

Gene Draze, Director
North Country Heavy Equipment School, LLC
2929 16th Avenue North
Escanaba, MI 49829		 Phone: 906-789-3123
Fax: 906-789-3124
Email:
info@RunMonsterMachines.com
Name:
Address:
City, State/Prov., Zipcode:
Area Code & Phone Number:
Email Address (required only if submitting on-line):

Please check the 2010 Heavy Equipment course in which you are currently enrolled or plan to attend:

April 5 - April 23 June 28 - July 16 Aug. 30 - Sept. 17
April 26 - May 14 July 19 - Aug. 6 Sept. 20 - Oct. 8
May 17 - June 4 Aug. 9 - Aug. 27 Oct. 11 - Oct 29
June 7 - June 25        

Please check the 2010 HAZWOPER class in which you want to enroll:

April 23 - 25 July 16 - 18 Oct. 8 - 10
June 4 - 6 Aug. 27 - 29    

The cost for the HAZWOPER training is $700. Arrangements for payment must be made before your class starts. How do you plan to pay for HAZWOPER? Please check one:

Personal Check / Money Order Agency / Loan Check Cash
Credit Card Other

Would you like someone to contact you with more information? Yes No Not Sure
Counselor Friend Someone who took the course
TV Radio Flyer
Newspaper Employment Office Website / Search Engine
Other
Please call if you have any questions, 906-789-3123.
Thank You For Your Application!

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