PLUMBERS CONTINUING EDUCATION

Robert (Bobby) D. Doran
1001 Haltom Road
Ft. Worth, Texas 76117
817- 222-1005 or 800- 445-1768
Fax: 817-222-1150

                                         Registration Form

Please Complete and Send to PCETX. This form may be photocopied.

Full Name:Plumber Type License #:Exp-Date:

Company or City Rep

Mailing Address: Tel #

City Sate Zip: Fax #

Desired Class Date: Location:

E-mail

Each Class is limited to 45 maximum people                

           6 Hour CPE Class - $85.00        26 Hour Code Training Course - $385.00

           40 Hour Code Training - $505.00 24 Hour Residential Fire Sprinkler Course $485

           10 Hr. Certified OSHA Course  CPE Correspondence Course $125.00

           16 Hour Math, OSHA, LPG & TAG Course $255.00

           24 Hour - Responsible Master Plumber Course $485.00

 

Check or PO#: Amount

Charge   American Express Master Card   VISA Discover Check   Cash

Card Number:                                   Expiration Date:

Name on Card:

CCV #(3 numbers on back): Zip Code on Card

Signature authorizing payment:

Please make your check payable to Plumbers Continuing Education at the above address.
Checks may be mailed or received at the training course.

                            Registration forms may be faxed, mailed, emailed or register by phone.

              Any further questions, call the number listed above or go to web site www.pcetx.com

Sends a copy immediately to Registration: