New Environment, Inc.
REGISTRATION FORM
PHONE #: 800.732.3073   FAX #: 330.759.7221		 Please Print Out This Registration Form And
Mail It In With Your Payment To:
New Environment, Inc.
PO Box 205
Brookfield, Ohio 44403
CLEVELAND OHIO SEMINAR TITLE:   (Select All That Apply)
Train-The-Trainer Instructor Program: $ 1475.00
40-Hour Hazardous Waste Worker: $ 395.00 24-Hour Emergency Response Technician: $ 395.00
8-Hour Hazardous Waste Refresher: $ 110.00 8-Hour Emergency Response Refresher: $ 110.00
DATE(s) OF TRAINING:  
STUDENT NAME:  
COMPANY NAME:  
COMPANY ADDRESS:  
CITY, STATE, ZIP CODE:  
PHONE NUMBER:  
FAX NUMBER:  
EMAIL ADDRESS:  
PAYMENT INFORMATION
P.O. NUMBER REQUISITIONER SEND INVOICE ATTN.
     
Check Or Money Order Enclosed, Made Payable To New Environment, Inc.
Credit Card Type:     American Express     VISA     Master Card     Discover Card
Name On Credit Card:  
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Expiration Date:  
Authorized Signature:  
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Total Amount Of Payment: $  
Please Email The Registration Confirmation

Please note that seminar cancellations received more than ten (10) days prior to class will be refunded less a 10% processing fee. Seminar cancellations made ten (10) or fewer days prior to class will receive a 100% "Tuition Credit". Our regularly scheduled seminar dates, times and locations are subject to change dependent upon response. Actual seminar location may be anywhere in the greater urban area of the cities listed.

All seminar tuition must be paid in advance of the class. Training certificates will not be mailed out until payment has been received.

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