Registration Form
In-House Trainer
Drug Screening Collector (6 hour
class) In-House Trainer (12 hour class)
Please choose the class date, and location and complete the following information to register.
You will receive a registration confirmation, including directions, within two business days.
ADATC will mail an invoice to the address you provide in the form below, or you may mail your payment to:
ADATC, PO Box 470194, Charlotte, NC 28247.
Payment must be received at least 10 days prior to class to reserve your
place as an early registrant.
In-House
Trainer
Registration:
$390.00
per person
$370.00
If early registration*
Certified
Collector
Registration:
$235.00
per person
$220.00
If early registration*
*Early registration is defined as payment received 10 days before
class starts
Class Dates and Locations
*IMPORTANT* Please complete the following:
Contact's First Name
Contact's Last Name
Company Name
Mailing Address
City
State
Zip Code
Telephone Number (please include area code)
Fax Number (please include area code)
Email Address
Attendee 1
Attendee 2
Attendee 3
Attendee 4
Attendee 5
Questions or Comments
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