Safety Registration Form Class Registration Please fill out a separate form for each class type. Class registration is closed out one week prior to class date. To see our class schedule and space availability, please visit: http://www.htahawaii.org/calendar/ Online class options are indicated below. For online classes, if applicable, class books will be mailed in advance of the class (~5 days prior), companies will be charged for the postage of books. Class registration is confirmed when an email reply from HTA is received. Please choose one: Driver Improvement | Member Price - $45, Non-Member Price - $75 and/or Online In HTA Classroom (803 Kamehameha Hwy, Suite 308, Pearl City, HI 96782) ADVANCE REGISTRATION IS REQUIRED. WALK-INS NOT ACCEPTED. Hazardous Materials Training | Member Price - $40, Non-Member Price - $70 and/or Online In HTA Classroom (803 Kamehameha Hwy, Suite 308, Pearl City, HI 96782) ADVANCE REGISTRATION IS REQUIRED. WALK-INS NOT ACCEPTED. Forklift Training (classroom) | Member Price - $40, Non-Member Price - $70 Online In HTA Classroom (803 Kamehameha Hwy, Suite 308, Pearl City, HI 96782) ADVANCE REGISTRATION IS REQUIRED. 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 (Classes 1-6) | Member Price - $50, Non-member Price $70 for first forklift; for additional forklifts $20 for members/$30 for non-members; for additional persons on the same date/timeframe, $20 for members/$30 for non-members Forklift Evaluation (Class 7) | Member Price starting from $60, Non-member Price from $90; for additional persons on the same date/timeframe, $20 for members/$30 for non-members; for additional forklifts $20 for members/$30 for non-members; for additional persons on the same date/timeframe, $20 for members/$30 for non-members Companies will be charged for ALL students who are confirmed for the class regardless of actual attendance, unless 48 hours' notice is given on non-attendance. NO SHOWS for classes will be given one chance to make up the class at no additional charge on a space available basis within the calendar year. When rescheduling the "free makeup class", please indicate on the side of their name, date of the class that individual missed (e.g. Maile Smith, n/s 1/1/24) For last minute cancellations or no-shows to road evaluations or forklift evaluations, a $50 fee will be charged, unless 48 hours' notice is given. For any pre-paid evaluations, any remaining balance will be held as a credit towards a makeup evaluation within the calendar year. For Heavy Equipment Training, CDL License Training, License Upgrade, Formal Training (e.g. Forklift) and Remedial Training, please contact Angelica at (808) 833-6628 or email at [email protected]. Class Date Requested: * Company Name: * Address: * Address: Completion certificates will be sent to this address. For in-person attendees, class tests and book receipts will be sent to this address. For online attendees, class books will be sent to this address in advance of the class. Completion certificates will be sent to this address. For in-person attendees, class tests and book receipts will be sent to this address. For online attendees, class books will be sent to this address in advance of the class. Address: City City State/Province AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming State/Province Zip/Postal Zip/Postal Name (First and Last Name): * Email: * All class communications will be sent to this email address after registration is confirmed. Telephone Number (please enter without dashes or commas; can include area code): * Please indicate best day-time phone number to contact. Payment Amount: *Billing option(s): Please invoice company (for HTA members in good standing only) Credit Card - 2% surcharge to be applied, see payment link at bottom of the form. Mailing in payment (for non-members, payment must be received prior to class registration being confirmed) Please indicate Name of Attendee(s). Please also include an email address if they are attending the training class online. Name (First and Last Name) * Completion certificates will be issued with the name entered here. Email For online attendees, the class link will be sent to this email 1-2 business days prior to the class. Name (First and Last Name) Completion certificates will be issued with the name entered here. Email For online attendees, the class link will be sent to this email 1-2 business days prior to the class. Name (First and Last Name) Completion certificates will be issued with the name entered here. Email For online attendees, the class link will be sent to this email 1-2 business days prior to the class. Name (First and Last Name) Completion certificates will be issued with the name entered here. Email For online attendees, the class link will be sent to this email 1-2 business days prior to the class. Name (First and Last Name) Completion certificates will be issued with the name entered here. Email For online attendees, the class link will be sent to this email 1-2 business days prior to the class. Add More Remove If you selected to pay via credit card, please click the following link and complete as required, then RETURN TO THIS PAGE (tab) to finish submitting the class registration form: Credit Card Payment Link Captcha Submit If you are human, leave this field blank.
