INSTITUTE for CROSS-CONNECTION CONTROL
FS / AWWA ENDORSED

Backflow Prevention Assembly Tester Training and Certification Course
Developed using accepted practices of the American Water Works Association (AWWA) guidelines as set forth in the AWWA Manual M14 in full compliance with the
Florida Administrative Code.

Plumbing Contractors, Underground Utility Contractors, Irrigation Contractors, Fire Protection Contractors, Maintenance Personnel & Water Purveyors
Course
Dates
Times

Backflow Tester Certification
(must attend all 4 days)

September 18 & 19, 2010
*September 25 & 26, 2010

8:00 am to 6:00pm
8:00 am to 6:00pm
Backflow Tester Review & Recertification

*September 26, 2010

8:00am to 6:00pm
* DRESS PROPERLY FOR WET LAB WORK

SPACE IS LIMITED
We can not accept enrollments without payment
CALL TODAY TO RESERVE YOUR SEAT 1-800-277-8877
Backflow Tester Certification
$525.00
Backflow Review & Recertification
$175.00

Class Location : 6750 Pembroke Road, Hollywood, FL  33023

I am hereby enrolling in the following course

Backflow Tester Certification $525.00
Backflow Tester Review & Recertification $175.00
Total $______________

PAYMENT MUST BE MADE 2 DAYS PRIOR TO CLASS
Enrollments at door (if space available) $20.00 additional

Reschedule Fee: $150.00 Certification, $75.00 Recertification
NO REFUNDS

Enroll by phone (954) 961-4560 or 1 (800) 277-8877 or Fax (954) 963-2872
with Visa MasterCard American Express

Credit Card Account #:________________________________Exp___________________

Class Date________________________________________________________________

Name____________________________________________________________________

Address__________________________________________________________________

City_______________________________State_______________Zip_________________

Phone_______________________________Fax_________________________________

Recertification Tester Certification #___________________________________________

Email___________________________________________________________________

*** Class is good for 7 hours Continuing Education for the CILB ***

Send checks to:
Institute for Cross Connection Control
6750 Pembroke Road, Hollywood, FL 33023

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