Safety Class Registration

* Events and Class Registration (Please fill out form for each class. Classes are closed out one week prior to class date.)

Please choose one or two of three classes available.

Driver Improvement: Member Price - $45, Non-Member Price - $75 and/or

Online or

(In HTA Classroom)

PLEASE NOTE NEW ADDRESS FOR IN CLASS ON CALENDAR. WALKINS NOT ACCEPTED

Hazardous Materials Training: Member Price - $40, Non-Member Price - $70 and/or

Online or

(In HTA Classroom)

PLEASE NOTE NEW ADDRESS FOR IN CLASS ON CALENDAR. WALKINS NOT ACCEPTED

Forklift Training (classroom): Member Price - $40, Non-Member Price - $70

Online or

(In HTA Classroom)

PLEASE NOTE NEW ADDRESS FOR IN CLASS ON CALENDAR. WALK INS NOT ACCEPTED

Road Evaluation Member Price: $70, Non-member Price - $110

Pre Trip Coaching for License Upgrade (2 hrs): Member Price - $140, Non-member Price - $220 (AirBrakes not included)Pre Trip Coaching for License Upgrade (2 hrs): Member Price - $140, Non-member Price - $220 (AirBrakes not included)

Forklift Evaluation: Member Price - $30, Non-member Price $60 for first forklift; additional $20 for member/$40 for non-member (Classes 1 - 6)

Class 7 - Forklift Evaluation: Member Price starting from $60, Non-member Price from $90

*Companies will be charged for All students who are confirmed for the classes regardless of actual attendance, unless two working days notice is given on attendance.

*For Heavy Equipment Training, License Upgrade and Formal Training, please contact Lynn at (808) 833-6628 or email at accounts@htahawaii.org.

Date *

Company Name: *

Address *

Address

City

State/Province

Zip/Postal

Country

Telephone Number (please enter without dashes or commas; can include area code) *

Please indicate best day-time phone number to contact.

Email *

Name (First and Last Name) *

Payment Amount

*Request for billing option (HTA members in good standing only)

Please invoice me

Credit Card form attached - 2% surcharge to be applied

Mailing in payment

Please indicate Name of Drivers and Email address required for online training

Name (First and Last Name)

For Credit Card Payment

If you would like to pay via credit card, please copy and paste the following page link and complete as required: https://www.htahawaii.org/chgcdform/

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