Sewage Enforcement Officer's Precertification Academy Official Registration Form

Please fill out, print, and mail this registration form and check to: PSATS, 4855 Woodland Drive, Enola, PA 17025
If you would like to pay by credit card, please call Kathy Kronicz at (717) 763-0930.
PLEASE SELECT YOUR 1ST, 2ND, AND 3RD CHOICES.
2009 SEO Academy - Enola (May)
Cumberland County
PSATS Training Center

2009 SEO Academy - State College (July)
Centre County
Nittany Lion Inn

Name:
Position/Title:
Social Security Number:
Local Agency (if applicable*) or Organization
Address:
City:
State: Zip Code:
County:
Daytime Phone #:
 Fax #:
Cell Phone #:
   Email:
Special Needs?
May your name be given out to employers looking for SEOs? Yes          No

*To be given one of the priority seats reserved for local agency SEOs, you must include a letter on official letterhead from an appropriate local agency official, stating that you will be employed as a primary or secondary SEO for the local agency upon successful completion of your certification.