* Select the class location you wish to attend: Select One Council Bluff, IA - Jan 3 Newton, IA - Jan 4 Waterloo, IA - Jan 6 Davenport, IA - Jan 7 * Name: Name: Name: Name: CALIBRATION: Select one YES NO CALIBRATION: Select one YES NO CALIBRATION: Select one YES NO CALIBRATION: Select one YES NO * Company or Organization: * Address: * City: * State/Prov: * Country: * Zip/Post.code: * Phone: * E-mail: * Registration Fee Calculator Special Certification Class $150.00 / each 0 1 2 3 4 5 6 7 8 9 10 Please pay this amount: * Method of Payment: Select One Check Credit Card Money Order Credit Card information MUST be called in to 888-305-5292. NOTE: Other methods of payment must include check or Money order number Mail payments to: Total Backflow Resources P.O. Box 86 Salix, IA 51052 NOTE: Cancelations within 7 days of class start date will be refunded 50% of registration fee. Cancelations within 3 days of class start date will NOT be refunded. * denotes a field that must be completed BEFORE you click submit.
* Select the class location you wish to attend: Select One Council Bluff, IA - Jan 3 Newton, IA - Jan 4 Waterloo, IA - Jan 6 Davenport, IA - Jan 7
* Name:
Name:
CALIBRATION: Select one YES NO
Special Certification Class $150.00 / each 0 1 2 3 4 5 6 7 8 9 10
* Method of Payment: Select One Check Credit Card Money Order
Credit Card information MUST be called in to 888-305-5292.
NOTE: Other methods of payment must include check or Money order number
Mail payments to: Total Backflow Resources P.O. Box 86 Salix, IA 51052