REGISTRATION FORM FOR FOOD MANAGER CERTIFICATION COURSE
Mid-Bergen Regional Health Commission is offering a Food Manager’s course and certification exam on Tuesday, February 21, 2012 and February 28, 2012 from 4:00 PM to 8:00 PM. You Must attend both sessions. (DOORS CLOSE AT 4:00 PM, THERE WILL BE NO ADMITTANCE AFTER START TIME.) This two day course will culminate with a Food Safety Manager’s certification exam prepared and graded by The National Registry of Food Safety Professionals. (This is a nationally recognized certification.) The Cost of the course is $165 per person; this includes the certification exam, textbook and handouts.
PLACE: River Edge Municipal Building
705 Kinderkamack Road
River Edge, NJ 07661
(Parking and Entrance on Tenney Avenue)
*You must bring a photo ID, a #2 pencil, and a Certified Check or Money Order for $165.00 made payable to Mid-Bergen Regional Health Commission.
Seating is limited so please register early. Please register by completing the following application form and send via email to rehsmid1@aol.com. Applications must be received by February 6, 2012.
____________________________________________________________________________
PLEASE PRINT CLEARLY AND INCLUDE ALL REQUESTED INFORMATION
Name of Establishment: ________________________________________________
Address of Establishment: ______________________________________________
Phone Number of Establishment: _________________________________________
Name of Employee/Manager attending the course: ___________________________________________________
Email address contact: _______________________________________
*Any Questions regarding this course should be forwarded to rehsmid1@aol.com.
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