Online Training Registration

Cost: $145.00 per day/person

Please select Registration Method.

You can either fill out form below to register online and then call with payment information,
or Download Registration Form and print, fax, mail or email.

*Required

Company Name*

Person Authorizing Training*

Select Training*

Class begins at 8 am (EST)

Date(s) for training* (Format mm/dd/yyyy)

Does your company have a training plan?*

Check One

Check All That Apply
SurfaceUndergroundMetalNon-MetalCoal

Student Full Name for Certificate:*
ONLY One Per Registration Form

Address for mailing Certificate(s)*:

Attention

Phone Number we can reach the student on training day:*

Email Address to Send Class Materials & Class Link to:*

By signing below, you agree "I have read the above information and agree that all terms and statements are correct. Furthermore, I verify that the above named person is attending this class." False certification of training documentation is punishable under section 110(a) and 110 (f) of the Federal Mine Safety and Health Act (P.L. 91-173 as amended by P.L. 95-164)

Signature: Use your mouse to write below. *Required

Print Name*

Date* (Format mm/dd/yyyy)

Click Continue, you will then be taken to the payment section.
The cost for the open class is $145 per person per day.