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OTI 511 - Occupational Safety and Health Standards
For General Industry

Registration Form
(Items in Red are required fields)

First Name
Last Name
Degrees
Prof. Title
Gender Male Female
E-mail
Home Phone
Work Phone
Fax
Company
Department
Address
Address2
City
State
Zip
Country


Would you like to apply for General or American Board of Industrial Hygiene CEU's

ADA Describe Any Disabilities

DISCOUNT CODE:


Notes/Comments
Registration Dates, Locations and Fees
Please check which course you are registering for.

Course Registration: $750.00

 
Location
Start Date
End Date
2009
Jacksonville, FL
November 16
November 19
Fort Pierce, FL
November 30
December 03
Tampa, FL
December 7
December 10
Orlando, FL
December 14
December 17
2010
West Palm Beach, FL
January 04
January 07
Orlando, FL
February 15
February 18
Nashville, TN
March 01
March 04
Naples, FL
March 02
March 05
Clearwater, FL
March 29
April 01
Daytona Beach, FL
April 12
April 15
Tampa, FL
May 17
May 20
Columbia, SC
June 07
June 10
Miami, FL
June 28
July 01
  Daytona Beach, FL
July 26
July 29
  Orlando, FL
August 16
August 19
  Tampa, FL
September 20
September 23
  Fort Myers, FL
October 05
October 08
  Jacksonville, FL
October 12
October 15
  Fort Lauderdale, FL
November 15
November 18
  Orlando, FL
November 29
December 02
Payment Method
(Note: You will not be charged until registration is confirmed.)

Cancellation Policy
Cancellation notification must be in writing (FAX or email are acceptable). A cancellation fee equal to 25% will be assessed. Written cancellations received less than 5 working days prior to the event will be charged the cancellation fee plus the per-person cost. No-shows will be billed. Substitutes are welcome without penalty.

The Continuing Professional Education Office at the University of South Florida Health Sciences Center reserves the right to cancel this activity due to unforeseen circumstances. In the event of such cancellation, only the registration fee will be returned to the registrant.


Credit Card
Mastercard
Visa
American Express
Name (exactly as on card)
Credit Card Number
Expiration Date (mm/yy)
CVC Code


Check
Please make checks payable to:

USF HPCC
PO Box 864240
Orlando, FL 32886-4240

On your check, please include the program code which is printed on your confirmation and the registrants name or a copy of the registration.
Bill Later For Registrations Paid By PO
PO Number
 
If billing address is different than above - please list below
Company
Attn:
Address
City State Zip
Phone EMAIL


Security Notice

Accommodations for Disabilities: Please notify the CME Office, 12901 Bruce B. Downs Blvd., MDC Box 60, Tampa, Florida, 33612 or call (813) 974-6695 a minimum of ten working days in advance of the event if a reasonable accommodation for a disability is needed.

Events, activities and facilities of the University of South Florida are available without regard to race, color, sex, national origin, disability, age, or Vietnam veteran status as provided by law and in accordance with the University's respect for personal dignity.