school bus driver refresher training class registration form
school bus driver refresher training class registration form
school bus driver refresher training class registration form
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SCHOOL BUS DRIVER REFRESHER TRAINING CLASS<br />
REGISTRATION FORM<br />
This <strong>form</strong> must be completed and faxed to the Regional Office no later than MONDAY, JUNE 25, 2012 - FAX: 815-947-2717<br />
Date / Time of Class:<br />
Thursday, June 28, 2012 / 7:00 p.m. - 9:00 p.m. (Eastland Middle School-Shannon)<br />
Employer Name:<br />
Employer Address:<br />
City, State, Zip<br />
Employer Phone:<br />
Please complete all the in<strong>form</strong>ation for each person attending.<br />
EMPLOYEE NAME<br />
(Please Print) DRIVER'S LICENSE #<br />
DATE OF HIRE<br />
INITIAL OR<br />
REFRESHER<br />
TRAINING<br />
(I / R)<br />
Thursday, June 28, 2012 - Shannon
EMPLOYEE NAME<br />
(Please Print) DRIVER'S LICENSE #<br />
DATE OF HIRE<br />
INITIAL OR<br />
REFRESHER<br />
TRAINING<br />
(I / R)<br />
Thursday, June 28, 2012 - Shannon
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