Course Registration Form

Please fill out the below registration form and submit for registration. Someone from our office will contact you within 24 hours to confirm your registration and method of payment for the class. Seating is limited, so do not delay. If you have questions or problems with the registration form, please contact our office at 800-560-7903.

* ALL SECTIONS MUST BE COMPLETED!

Company Information



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PERSONAL INFORMATION



Please Select Your State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming




HOW DID YOU HEAR ABOUT US? WHAT WOULD YOU LIKE TO LEARN FROM THIS CLASS? QUESTIONS OR COMMENTS *

Please inform us of any special meal requirements at time of registration

**PLEASE NOTE: IICRC Water Damage Restoration Technician is a requirement for certification in Applied Structural Drying and Applied Microbial Remediation Technician.

Exam fees are additional and must be paid at time of exam. IICRC exam fees are $50 per person. Payment for IICRC exam fees can be paid by credit card or check made payable to IICRC directly.

Cancellation Policy:  A $50.00 cancellation fee will be charged to student if cancelled 10 days prior to class. 3 days prior to class will be charged in full, but can be applied as a credit to future classes.