Course Registration Form

Continuing Education Registration Form

Please fill out this form fully to register for classes.
Date: OCTOBER 18TH

Time: 7:00 AM

Location: Black Hawk Labor Temple (1695 Burton Ave. Waterloo, IA 50703)

Lunch and refreshments will be provided for those attending both sessions. Please contact Christina Henzen at apprenticeship@ibew288.org
Name*

First NameMiddle NameLast Name
License #*
Last Four # of SSN*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
E-mail*
example@example.com
Phone Number*
ARC FLASH & NFPA 70E TRAINING - 3 HOURS (Code and Non-Code Hours)

Please register me for this class.
HAZARDOUS LOCATION FUNDAMENTALS - 3 HOURS (Code Hours)

Please register me for this class.
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Continuing Education Registration Form