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On-Site Request Form
On-Site Request Form
All on-site classes will be charged the cost of class per student (minimum of thirty students), cost of on-site proctor ($200.00 per class), cost of mileage to and from ISTC, and cost of SSV ($6.00 per person). If the on-site training location exceeds a 60-mile radius from an ISTC location, the customer may be charged additional cost based on the location of the training site. All on-site registration must be completed online by customer prior to on-site or an additional $125.00 administrative fee will be charged. If the customer wishes to pay the administrative fee, requiring ISTC to schedule, a list of individuals attending training must be submitted to training@istc.net by 12:00 PM (CST) the day before the scheduled class. The list must include the last six digits of the trainees’ social security number, name (first and last), and classes needed.
ISTC shall provide the following classes at the request of:
Company Name
Client ID
Company Contact Name
First
Last
Primary Phone Number
Email
Requested Courses
Requested Date
MM slash DD slash YYYY
Requested Time
:
Hours
Minutes
AM
PM
AM/PM
Number of Students
PO #
Address where class will be given
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Insurance Requirements To Enter Facility
Specific PPE Requirements to enter facility
Company Representative Name
First
Last
Company Representative Signature