Safety Regulations Workshop

ARE YOU RESPONSIBLE FOR:
Driver compliance? Driver files? Driver testing or training? Maintenance files? Vehicles?
Keep yourself out of trouble by attending our Safety Regulations Workshop covering:
Part 382 – 396 of the federal motor carrier safety regulations, and pertinent state safety regulations

January 15-16, 2013: HTA Classroom – 2850 Paa Street Room 204  4:30pm-7:30pm

Fill out our online form below or print and fill out with this downloadable form – Click Here.

Registration Form - HTA Spring Golf Tournament

REGISTRATION

Please complete the form below.

If you prefer to print and email/mail a copy to HTA, please download the form here: click here.

Company *

Name *

First

Last *

Last

Email *

Work Phone

Cell Phone

GOLFER DETAILS

Team Details

Golfer #1

Golfer #1

First

First

Last

Last

Golfer #1 Email

(optional) to be used to communicate event details.

Golfer #2

Golfer #2

First

First

Last

Last

Golfer #2 Email

(optional) to be used to communicate event details.

Golfer #3

Golfer #3

First

First

Last

Last

Golfer #3 Email

(optional) to be used to communicate event details.

Golfer #4

Golfer #4

First

First

Last

Last

Golfer #4 Email

(optional) to be used to communicate event details.

Add Additional Team Remove Team

PAYMENT DETAILS

Mail cash or checks payable to Hawaii Transportation Association to P.O. Box 30166, Honolulu, HI 96820.

For credit card payments, use the credit card authorization form below.

Number of Teams ($800/team)

1 Team2 Teams3 Teams4 Teams5 Teams6 Teams7 Teams8 Teams

Sponsor A Hole ($150/hole, no limit)

No Sponsor1 Hole2 Holes3 Holes4 Holes5 Holes6 Holes7 Holes8 Holes9 Holes10 Holes11 Holes12 Holes13 Holes14 Holes15 Holes16 Holes17 Holes18 Holes

Total:

How do you plan to pay?

Credit Card (2% credit card processing fee will be added)

Business Check

Cash

Thank you for Registering. Please fill out the form below if you would like to have us charge you via credit card.

Name of Cardholder (as it appears on the card): *

Email Address for Receipt: *

After payment is processed by HTA, a receipt will be emailed to this email address.

Billing Address of Cardholder: *

Billing City/State/Zip: *

Please note the class, event, invoice #, etc. for this payment: *

Card type: *

Master Card

Visa

American Express

Amount of transaction authorized ($): *

Do not include the 2% surcharge, this will be automatically calculated and added by HTA.

Credit Card Number: *

Expiration (MM/YYYY): *

3 or 4-digit CVC Code: *

Phone (XXX-XXX-XXXX) *

Signature (By writing out your full name below, you agree to the amount of this transaction and authorize HTA to charge the total to the credit card provided above): *

Submit

If you are human, leave this field blank.