ServSafe Food Safety Manager Certification Class

REGISTER EARLY! CLASS WILL FILL UP

Registration Form

Today’s Date: _____________________

Course Date: Wednesday, May 20, 2009

Course Location: U.S Foodservice, 300 Lawrence Drive, Livermore CA 94550

Time: Registration – 7:30am – 8:00am Class – 8:00am – 4:00pm Lunch – 12:00pm – 1:00pm

U.S Foodservice Customer ID# _________________________(required for discount) $99.00

(Non U.S Foodservice Customers $170.00 per person)

Fee Enclosed: $ _______________

REGISTER AT LEAST ONE WEEK IN ADVANCE OF THE SERVSAFE CLASS!!!
TO RECEIVE YOUR STUDY MATERIALS

Name: ___________________________________________________


Company: _______________________________________ Title: ____________________________


Address: __________________________________________________________________________


City: ___________________________________ State: ___________________ Zip: ____________


Daytime Phone: _________________ Fax: ________________ Email: ____________________

Payment Method: Mail Registration and Payment to Hospitality Consultants of America, 716 Lighthouse Avenue, Suite G, Pacific Grove, California 93950

Your Registration is Confirmed When the Registration Form & Payment Have Been Received.

Make checks payable to: Hospitality Consultants of America

Telephone: 1-800-953-3822 for inquiries

Course Material Requested: English _________ Spanish _________