Wilbur Wright College
Mold Investigation and Monitoring
REGISTRATION FORM

1) Select Class
Mold Investigation and Monitoring
Mold Remediation
Mold Investigation Refresher
September 23 & 24, 2003
October 21, 22, & 23, 2003
November 18, 2003
$495.00
$695.00
$295.00
2) Fill Out Form
First Registrant
Second Registrant
Name: 
Title:
Company:
Address:
City, State, Zip Code:
Phone:
Fax:
E-mail:
(Required) Social Security #:
3) Complete Registration

Please enclose check or money order payable to Wilbur Wright College with your registration form.

Mail to:

Victoria Cooper, Ph.D.
Director of the Environmental Technology Department
Wilbur Wright College
4300 N. Narragansett
Chicago, IL. 60634

To insure registration and secure your spot, copy and paste completed form into e-mail to Victoria Cooper, Ph.D. Payment by mail must be received 10 days prior to class along with copy of registration form.
2ABIHCM Points Awarded Upon Completion of Course
ASSECEU 's Applied For
IICRCCEC's Applied For