Course Desired (Please Circle One):

-------TESTER-------SPECIALIST-------REFRESHER-------TRAINING -------CONTACT HOURS

Date Desired:_______________________________________

ABOUT THE STUDENT:

Name: ______________________________________________________
Mailing : _____________________________________________________
Street Address (If Different): _______________________________________
City______________________________State:________Zip:___________
Phone:__________________FAX:_______________Cell:_______________
e-mail:__________________________________________________

Payment must be made prior to the beginning of the specific course.
Tester Course $800.00. 10% discount if paid (or PO received) 30 days in advance of start date.
Materials Provided: Text Book, Current Edition of Manual of Cross Connection Control

Specialist Course $850.00. 10% discount if paid (or PO received) 30 days in advance of start date.
Materials Provided: Text Book, Current Edition of Manual of Cross Connection Control, Current Edition of AWWA Manual M-14.

Contact Hour Classes: $160.00/ 4-Hour Session; $250.00/8-Hour Session.

Refresher Training $125.00. $25.00 Discount if Pre-paid 30 days in advance.
Materials Provided: Text Book.

 

NOTE: Course fees do not include the certification examination fee charged by the California-Nevada Section of the American Water Works Association. That fee must be paid to the Section at the time of application for the certification examination.

 

NOTES:

1) Payment (or PO) 30 days in advance yields 10% Discount

2) Certification Exam Fees are separate from course fees and are paid directly to the AWWA - California-Nevada Section.

Payment Method:

Checks can be made payable to either:
Taurus Engineering & Testing Service or
Able Backflow Academy

Purchase Orders can be made to either:
Taurus Engineering & Testing Service or
Able Backflow Academy

Credit Card: VISA MasterCard (No others accepted)
Credit cards will be run by Taurus Engineering & Testing Service.

PAYMENT METHOD (Please Circle One):

-------MasterCard -------VISA -------Cash/Check -------Purchase Order

Name of Student:_______________________________________________
Name on Card:_________________________________________________
Telephone Number (If Name on Card different from Name of Student):
(________) _________________________________________
Credit Card Number:_____________________________________________
Expiration Date:_________________________________
CCV (last three digits on back):_____________________

If Payment is by Purchase Order or 3rd Party Payer:
Company/Organization:

Name:____________________________________________________
Attention To:_______________________________________________
Billing Address:_______________________________________________
City:___________________________State:________ZIP:_____________
Mailing Address:______________________City:_____________State:_____ZIP:______

Please visit our web site for more information on schedules, fees, etc.
www.ablebackflowacademy.com
All 40-hour courses include continental breakfast each day
and a sandwich buffet at lunch with various beverages (diet/regular/decaffeinated).
If sufficient numbers register 30 or more days before a 40-hour class,
the certification exam will be held the afternoon of the last day of the course at the Academy.
Tester Classes limited to 10 students to ensure that each student has a
test stand and a gauge for practice in the wet lab.

PLEASE FAX APPLICATION TO: (209) 473-8109