Sewage Enforcement Officer (SEO) Precertification Academy Official Registration Form

Please fill out, print and mail this registration form and check to: PSATS, 4855 Woodland Drive, Enola, PA 17025
If you would like to pay by credit card, please call Kathy Kronicz at (717) 763-0930.
Please select:
Orientation Course $100
Precertification Academy Course $ 800/ $300**
2011 SEO Academy – Enola, PA
April 26, 27, 28 / May 3, 4, 5
Cumberland County
PSATS Training Center
  

 
Note: Payment for the courses you have selected must be included with this registration form.
Name:
Position/Title:
Company / Organization:
Sponsoring Municipality:
Mailing Address:
City:
State: Zip: County:
Daytime Phone Number:   Fax Number:
Cell Phone:   Email Address:

REFUND POLICY
Orientation Course - $100 for sponsored / nonsponsored individuals. This fee is nonrefundable. A full refund may be granted up to 60 days prior to the course. Substitutions will be accepted.

A full refund of the academy registration fee may be granted up to 60 days prior the course. Substitutions will be accepted.

Precertification Academy Course - $ 300 for sponsored individuals / $800 for nonsponsored individuals

**To qualify as a local agency-sponsored candidate, you must submit, with your registration form, payment directly from the municipality (local agency) for the academy course registration fee.
A local agency is defined as a municipality, a county, a county department of the health, or a joint county department of health.

I understand the payment and refund policy. _______________________________________________________________________
 
Signature Date