Transcription of Worker Registration Form - norcat.org
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Worker Registration Form - norcat.org
Completed forms can be emailed to the respective training location, listed above, at least 2 days prior to the chosen session date or faxed to 705-670-2193 (fax for Sudbury location only). Reservations are subject to you attached any additional external documentation (MLTSD records, WHMIS or Fit Tests)? Yes NoNORCAT No. (if available): _____ Birth date (MM/DD/YYYY): _____ Worker 's email:_____ Last Name: _____ First Name: _____ Home Phone #:_____ Trade: _____ Company Name:_____ Company Contact:_____ Company Phone #: _____ Company Email:_____ SUDBURY 1545 Maley Drive Sudbury, ON P3A 4R7 GTA 151 Superior Blvd. Unit 8-10 Mississauga, ON L5T 2L1 TIMMINS 76 McIntyre Road Schumacher, ON P0N 1G0 THUNDER BAY 399 Mooney Avenue Thunder Bay, ON P7B 5L5 DateTheory Date:(MM/DD/YYYY): _____ Practical (if required):(MM/DD/YYYY): _____ Method of Payment Cheque* Debit Cash PO_____ * Personal cheques not accepted Amex MasterCard VISACard Holder:_____Card #: _____ Expiry Date: _____ IMPORTANT!
To register for training and reserve a seat, please complete this form and fax it to NORCAT at 705-670-2193 or e-mail to sudbury@norcat.org at least 2 days prior to the chosen session date.
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