Applicant's Information
See below if registering more than one applicant for your facility
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Grade 12 or GED Completed?
Please Select
Yes (Please upload proof of completion)
No
Please upload your proof of Grade 12/GED completion
Browse Files
Drag and drop files here
Choose a file
Cancel
of
2000 Hours Completed
Please Select
Yes (Please upload proof of hours)
No (Must be completed before certificate is awarded)
*Please upload proof of your completed 2000 hours
Browse Files
Drag and drop files here
Choose a file
*Must be completed prior to certificate being awarded. Please see the Proof Of Hours form on our website.
Cancel
of
Date of Birth
*
-
Month
-
Day
Year
Date
SIN Number
Driver's License Master's Number
*
Facility's Information
Facility Name
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Chief Engineer
*
First Name
Last Name
Chief Engineer's Email
*
example@example.com
Ticket Number
*
How many participants are you registering?
*
Please Select
1
2
3
Please add additional participants below.
Additional Applicants Information
If you are registering more than ONE participant, please fill out the below.
Second Applicant's Information
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Grade 12 or GED Completed?
Please Select
Yes (Please upload proof of completion)
No
Please upload your proof of Grade 12/GED completion
Browse Files
Drag and drop files here
Choose a file
Cancel
of
2000 Hours Completed
Please Select
Yes (Please upload proof of hours)
No (Must be completed before certificate is awarded)
*Please upload proof of your completed 2000 hours
Browse Files
Drag and drop files here
Choose a file
*Must be completed prior to certificate being awarded. Please see Proof Of Hours form on our website.
Cancel
of
Date of Birth
-
Month
-
Day
Year
Date
SIN Number
Driver's License Master's Number
Third Applicant's Information
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Grade 12 or GED Completed?
Please Select
Yes (Please upload proof of completion)
No
Please upload your proof of Grade 12/GED completion
Browse Files
Drag and drop files here
Choose a file
Cancel
of
2000 Hours Completed
Please Select
Yes (Please upload proof of hours)
No (Must be completed before certificate is awarded)
*Please upload proof of your completed 2000 hours
Browse Files
Drag and drop files here
Choose a file
*Must be completed prior to certificate being awarded. Please see Proof Of Hours form on our website.
Cancel
of
Date of Birth
-
Month
-
Day
Year
Date
SIN Number
Driver's License Master's Number
Applicants who do not have permanent residency in Nova Scotia must submit a copy of their valid work permit, as well as, if applicable, their study permit.
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Is this your first time attending?
*
Please Select
Yes
No
How did you hear about the Second-Class Refrigeration Arena Course?
*
Are you a MEMBER of RFANS:
*
Please Select
Member
Non-Member
Would you like to become a MEMBER of RFANS:
*
Please Select
Please contact me
Do not contact me
Date
*
-
Month
-
Day
Year
Date
How would you like to pay?
*
Master Card
Visa
American Express
PayPal
Invoice
Method of Payment
MasterCard
VISA
American Express
Paypal
Invoice
Other
My Products
prev
next
( X )
Second-Class - Member Fee
$
500.00
CAD
Quantity
1
2
3
Item subtotal:
$
0.00
CAD
Second-Class - Non-Member Fee
$
750.00
CAD
Quantity
1
2
3
Item subtotal:
$
0.00
CAD
Submit
Payment Methods
Debit or Credit Card
Choose from one of the PayPal options to
make your payment.
Should be Empty: