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English (US)
ILICA Safety Workshop Registration Lanark, IL
Please register by filling out the form below; specify the expected number joining each certification course.
Full Name
*
First Name
Last Name
Company Name
E-mail
*
example@example.com
Phone Number
*
Number of people attending
*
Additional attendees' names
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Certification Training(s): Member's employees eligible for member prices. Daily lunch and snacks included with registration. Note: Flagger & CPR trainings are concurrent on the second day, meaning individuals can only register for one or the other.
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( X )
10 HR OSHA: Jan. 7-8 (member)
Training ends at noon on second day
$
75.00
Quantity
1
2
3
4
5
6
7
8
9
10
Flagger: Jan. 8 (member)
12 - 5 pm
$
75.00
Quantity
1
2
3
4
5
6
7
8
9
10
CPR: Jan. 8 (member)
12 -5 pm
$
30.00
Quantity
1
2
3
4
5
6
7
8
9
10
10 HR OSHA: Jan. 7-8 (non-member)
Training ends at noon on second day
$
95.00
Quantity
1
2
3
4
5
6
7
8
9
10
Flagger: Jan. 8 (non-member)
12 - 5 pm
$
95.00
Quantity
1
2
3
4
5
6
7
8
9
10
CPR: Jan. 8 (non-member)
12 -5 pm
$
50.00
Quantity
1
2
3
4
5
6
7
8
9
10
Credit Card
First Name
Last Name
Credit Card Number
Security Code
Expiration Date
Postal Code
Register
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