ISTC Client Information Forms

INDUSTRIAL SAFETY TRAINING COUNCIL - CLIENT INFORMATION PACKET

All information must be provided before the application will be processed. This information will be used for the sole purpose of maintaining a client database and will not be shared.

Company Contact / Training Registration Administrator

Name*

First Last

Title*

Email Address*

Phone*

Fax

Billing Contact

Name*

First Last

Title*

Email Address*

Billing Address*

Billing Street Address Billing Address 2 Billing City Billing State/Province Billing Zip/Postal Code

Phone*

Fax

Subscriber: $375.00 Annual fee. ISTC Subscriber client benefits include scheduling courses, a reduction in class cost, 30-day net billing, option to change payment type to COD to allow student to pay at time of training, and access to setup a background account with all pre-selected ISTC background vendors.

If at any time the account becomes delinquent, the client understands that they will forfeit all subscriber rights and privileges until the account is made current.

ISTC Client Information Forms

Step 1 of 2

INDUSTRIAL SAFETY TRAINING COUNCIL - CLIENT INFORMATION PACKET

Company Information

Company Contact / Training Registration Administrator

Billing Contact

INDUSTRIAL SAFETY TRAINING COUNCIL - CREDIT CARD AUTHORIZATION FORM

Participant Name/Invoice #	Course(s)	Date