T.W.U.A. COURSE REGISTRATION FORM (Note: Please Print Legibly)
TO REGISTER FOR ANY OF THESE CLASSES, GO TO WWW.TWUA.ORG/TRAINING.HTM
Name:____________________________ E-Mail Address:____________________________________ Course Name: ______________________________ Date:__________________________________ Location:___________________________________________ Fee: ___________________________ Home Address:____________________________ City:_____________State:_____ Zip:___________ Day Time Phone #:______________________ SS# or W/WW License number#:_________________ Company Name:____________________________ TWUA Member/Non-Member_________________ Visa/MC Acct. #:__________________ ___________________Expire Date: _____________________ Cardholder: __________________________________________________________________________ For credit cards please fax this form to 512/459-7124 Checks or money orders mail completed registration form along with payment to: Texas Water Utilities Association · 1106 Clayton Lane, Suite 112 West · Austin, TX 78723-1093, Phone: 512/459-3124 or 888/367-8982, FAX: 512/459-7124, Register on-line at www.twua.org To obtain TCEQ License Number: http://www.tceq.state.tx.us/nav/data/licensed_data.html
PLEASE CALL TO CONFIRM**
TRANSFERS: If you cannot attend a class, you may contact T.W.U.A. 48 hours in advance and transfer to a future class or you can transfer your registration to another person. A registrant may transfer twice without a service charge. Any additional transfers will be subject to a $25 transfer fee. CANCELLATIONS: If you must cancel attendance at a T.W.U.A. course, T.W.U.A. will provide a full refund if the cancellation is received 14 calendar days before the start of the class. Cancellations received less than 14 calendar days are subject to an administration fee of $25 if the class is less than 40 hours in length. Classes that are 40 hours in length are subject to an administration fee equal to 10% of the cost of the class. NO SHOWS: REGISTERED PARTICIPANTS WHO DO NOT CANCEL AND DO NOT ATTEND THEIR SCHEDULED CLASS ARE LIABLE FOR THE ENTIRE CLASS FEE.
Backflow Prevention Assembly Tester Course: (40 Hours) * (20 Students Max)
Pre-registration $460 Member, $510 Non-Member On-site Registration $510 Member, $560 Non-Member TCEQ Credit Hours: 12 hrs W/WW License - 12 hrs CSI - 12 hrs WTS - 12 hrs LI - 40 hrs BPAT 100 hours to an applicant for a Plumbing Inspector license (through TSBPE)
Backflow Prevention Assembly Tester REFRESHER: (24 hours) *(24 Students Max)
Pre-registration $245 Member, $295 Non-Member On-site Registration $295 Member, $345 Non-Member 8 hr Mod I: TCEQ Training credit for: 8 hrs BPAT, CSI, LI, W/WW & WTS Licenses 8 hr Mod II: TCEQ Training credit for: 8 hrs BPAT, CSI, LI, W/WW & WTS Licenses 8 hr BPAT PRACTICAL SKILLS REFRESHER: TCEQ Training credit for: 8 hrs BPAT ONLY License
Contact TWUA Central Office to schedule your next Backflow Training Course. (512)-459-3124
16 TEXAS WATER UTILITIES JOURNAL www.twua.org
March 2011