Registration Form

Please enter your information to register for RotoMasters^SMCertified Training.

Name*
Address*
City*
State*
Zip*
Phone*
Email Address*
Please note – No seats are guaranteed. You will receive a training packet via email once you are confirmed. Please remember to include your email in order to receive your training packet.
Training Dates: (2 day classes)
	08/05 – 08/06 09/09 – 09/10 10/07 – 10/08 11/04 – 11/05 12/02 – 12/03
Attendees: (Print name as it should appear on Certificate)
1) First Seat*
2) Second Seat
3) Third Seat
Special Request (example – dietary or accommodation requirements)


* Required