2019

CORPORATE REGISTRATION FORM  

THIS NEEDS TO BE COMPLETED EACH TIME YOU PAY FOR SOME OF YOUR EMPLOYEES - THEY REQUIRE THE LAST 4 DIGITS OF YOUR PAYMENT RECEIPT NUMBER

Please note that your employees / staff MUST use your company email wherever a FORM Box asks for it.

That way, their certification(s) will be emailed directly to your company offices.

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We do require a list of your employees who may be taking the online course.  (this list is changeable)

You may;

• enter their names in the form below

       OR

• send us your names via email

       OR

• email us a pdf file from an existing spreadsheet (may save a lot of typing)

This Form cannot be submitted until the missing fields (labelled below in red) have been filled in

S-100A Corporate MANAGEMENT Registration Form BB2B Once this form is completed and submitted you will be re-directed. You CANNOT ACCESS the course or exam from this registration form.

Please note that all fields followed by an asterisk must be filled in.

Company / Organization Name*

Business Phone #

Company Management Contact Name (FULL)*

YOUR BEST CONTACT PHONE NUMBER(S)*

E-Mail Address*

Web Site URL

Postal Mailing Address*

City*

State / Province*

Zip/Postal Code*

Country

Canada USA Other

Other Country

May we ask; How did you hear about us?

WSCA Silviculture Magazine Web Search Letter Worksafe BC Forestry Other Repeat Customer

Please let us know if you also require the extra wallet card to be mailed out. (We will invoice you appropriately - Thanks*

NO - We don't require the extra wallet card - Thanks YES - Please also mail out a wallet card ($6.00 per person)

Purchase Order Number if company uses them.

Comments or Suggestion Box

Please list personnel who will be taking the course - if you don't have enough space, please just send an email to: firesafetraining@gmail.com (This only needs to be completed once by your Company Contact / Admin. person)

When you "Submit Registration" you will be re-directed to our "HOME" page. Thank you.