REGISTER FOR A TRAINING COURSE

RADIATION SAFETY ASSOCIATES, INC. Register here for a Training Course!
CONTACT INFO
BILLING ADDRESS
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COURSE(S) YOU WISH TO ATTEND
Radiation Safety Officer	October 31-November 4, 2011 March 12-16, 2012 April 9-13, 2012 June 4-8, 2012 September 10-14, 2012 October 29-November 2, 2012
DOT Radioactive Shipper	November 7, 2011 March 19, 2012 April 16, 2012 May 14, 2012 June 11, 2012 September 17, 2012 October 1, 2012 November 5, 2012
Respiratory Protection...	May 21-23, 2012 September 24-26, 2012
HP Technician I	April 23-27, 2012 October 15-19, 2012
HP Technician II	May 7-11, 2012
PAYMENT INFORMATION*
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to set up a purchase order), please print out this form, or
download the form as a Word document and send it to us.

Radiation Safety Associates, Inc.
19 Pendleton Drive • PO Box 107 • Hebron, CT 06248
VOICE: 860.228.0487 • FAX: 860.228.4402 • EMAIL: info@radpro.com