SC DOT- Registration

SCDOT Certification Page

SC DOT
Certification Program

Important Terms
and Conditions

SCDOT's Inspector Certification Page

Sample Course Materials

Directions

Level 3 QC Manager's Course Registration Form
2007 / 2008 SC DOT Certification Program

Please register the following person for the above-mentioned short course.

Name of Person Filling Out This Form:

Name of Person Registering for Course:

Level 2s Certification #: ** Roadway Certification #:
**

Organization/Company:

District # for DOT:

Mailing Address:

City: State: Zip Code:

Telephone Number of Person Filling Out This Form:

Telephone Number of Person Registering for Course:

Fax Number of Person Filling Out This Form:

Fax Number of Person Registering for Course:

Email Address of Person Filling Out This Form:

Email Address of Person Registering for Course:

Course Dates for 2007 / 2008:

**indicates required fields

Registration Fee: $650.00 per person

Make Checks Payable to: Clemson University/CICA

Mail the check to:

Mrs. Myrtle Mraovich
CICA/Clemson University
200 Lowry Hall
Clemson, SC 29634-0912
Phone: 864-656-4183, Fax: 864-656-0124

Please Call Mrs. Mraovich To Make Sure of Space Availability Before Sending in Your Registration Materials.
Thank You.