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

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

Course Registration: $750.00

 
Location
Start Date
End Date
2008
West Palm Beach, FL
May 12
May 15
Tampa, FL
May 27
May 30
Jacksonville, FL
June 09
June 12
St. Petersburg, FL
June 24
June 27
Orlando, FL
June 30
July 03
Columbia, SC
July 21
July 24
Montgomery, AL
July 21
July 24
Orlando, FL
July 21
July 24
Charlotte, NC
August 18
August 21
Daytona Beach, FL
August 18
August 21
Orlando, FL
August 18
August 21
Tallahassee, FL
September 15
September 18
Tampa, FL
September 29
October 02
Pensacola, FL
October 06
October 09
West Palm Beach, FL
October 13
October 16
Orlando, FL
October 27
October 30
Mobile, AL
November 17
November 20
Orlando, FL
December 08
December 11
Plantation, FL
December 11
December 14
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.