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Backflow Prevention Assembly Tester (BPAT)

 
Registration Form

Backflow Prevention Assembly Tester
Hours:  40
Cost:  $525.00
HAC Course Code: 12-1200-08
Start Date:  August 6, 2012
End Date:  August 10, 2012
Time:  8:00 am - 5:00 pm
Location:  City  of Beaumont, Water Utilities, 1350 Langham Road, Beaumont, Texas 77707

Please fill out all the information below.  To complete registration, click the "Submit" button at the bottom of this page and you will be directed to the PayPal website for payment. 

Please note:  you do not need to have a PayPal account to submit payment on the PayPal website.  When you are directed to the PayPal page you will select "Don't have a PayPal account?  Use your credit card or bank card".  This selection will direct you to the credit card payment page.

This information will be used to prepare certificates and to submit training hours to TCEQ for credit.  Please enter information as you would like it to appear on your certificate.
First Name: *
Middle Initial:
Last Name: *
TCEQ License #/SSN: *
Title:
Representing:
Telephone: *
Email:
Mailing Address: *
Mailing Address 2:
City: *
State: *
Zip Code: *


    
If you prefer, you can print this form and mail with your payment to: 

Hardin & Associates Consulting, LLC
5005 W. Royal Lane, Suite 170
Irving, Texas 75063

Office:  972-823-8800
Fax:  972-823-8802

To print form click here.


Registration, Cancellation and Substitution Policy:

Each student must complete a registration form. Cancellations made one week prior to the class will receive a full refund. Personnel substitutions will be allowed.  Please notify Hardin & Associates if you will not be attending class and another individual will be taking your place.  Payment may be made by check, money order, MasterCard, Visa, Discover, American Express or PayPal.  In the event a class is canceled, all students will be given the option to re-schedule or receive a full refund.
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