ProSystems EnviroHealth L.L.C. ServSafe® Food Protection Manager Course Registration Form
Course Attendee's Name and Tel. No.: ______________________________________________
Course date(s) and Time: _______________________________________________________
Mailing Address (for sending certificate and course materials): _____________________________
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Email Address for sending course-related information and communications (optional; mailing address will be used if email address is not available): ____________________________________________
Name and Address of Food Establishment/Employer (optional): _____________________________
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Town, county and state in which food establishment employment is located: ____________________
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ServSafe® training is conducted at facilities that comply with Americans with Disabilities Act requirements, including wheelchair accessibility.
Please note if there are any requirements for other special needs accommodations with regard to the classroom or the method of examination administration. Also note if there are any special dietary needs, with regard to refreshments. (Please inform instructor of accommodation needs by 10 or more business days prior to the examination date.): ________________________________________________
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Standard fee for course: Eight-hour (one-day) course $250.00 Sixteen-hour (two-day) course $290.00
Other course hours/fee if listed: ______________
Payment amount enclosed: $_____________. (Check or money order payable to ProSystems EnviroHealth L.L.C. Full payment is required with registration form.)
Please mail your registration form and payment to: ProSystems EnviroHealth L.L.C., 233 Rock Road, #326, Glen Rock, NJ 07452.
The course fee includes the training, the current (6th) edition of the book for the course (ServSafe® Manager) and other training materials, the course examination and certificate, and refreshments. Lunch is not included.
Payment is non-refundable less than 30 days prior to the class, due to course location scheduling and the ordering of books. If unable to attend, you may allow another person to use the registration, provided the instructor gives written approval in advance. Note: Each student must bring a photo identification to class sessions and to the course examination.
Please contact ProSystems EnviroHealth L.L.C. by telephone at (201)741-5592 or at info@prosystemsfoodsafe.com for any information.
