Safety Training Schedule

On-site Questions? Call Desta in Charlotte at (704) 644-4221 or Matt in Raleigh at (919) 719-9818

National Safety Council Membership
Number of Full Time Employees	One Year
1-10	$399
11-49	$549
50-100	$749
101-500	$1099
501-1000	$1799
Questions? Call (704) 644-4221 or (919) 719-9814 or Scan our QR code

REGISTRATION (Pre-payment Required):

Course Title:

Course Location: Course Date:

Contact

NAME of Attendee: (Please Print) Full Name & Preferred Name JOB TITLE: COST:

Company Member # Non-Member

Address

City State Zip Code

Telephone Email

METHOD OF PAYMENT:

Total Amount Due:

	Payment enclosed (4135 S. Stream Boulevard, Suite L150, Charlotte, NC 28217 or 5171 Glenwood Avenue, Suite 105, Raleigh, NC 27612)
	Send invoice. P.O. # (With approved credit only – IF NO PO is required, enter authorizing person’s name)
	VISA/MC/Amex/Discover# Verification Code Expires

Cardholder Signature

E-MAIL REGISTRATION TO: destah@safetync.org in Charlotte susanm@safetync.org in Raleigh

Cancellation Policy: We hope you do not have to cancel, however, if you need to do so, cancellation notices need to be received in writing within 7 days prior to the beginning of class. Tuition will be refunded in full less cost of materials and in the form of payment received. Substitutions and/or reschedules are always welcomed. No shows and cancellation requests received after the start of the class will not be eligible for a refund. This policy will be enforced so please plan ahead if you need to cancel. The Council reserves the right to cancel a scheduled training session due to participation levels, instructor emergency, or other unanticipated circumstances.