Washington State Flagger Certification Class

Registration Form

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    Name: __________________________________                                Date: ___________________

    Mail Adrs: __________________________________                         Phone: ____________________

    City: ____________________________                 St: ___________                 Zip: _____________

    Date of Birth: ____________________                       Soc Sec# (last 5 digits):__________________

    E-Mail: _________________________                        

Please insert date of class you wish to attend _____________. The tuition cost must be paid in advance. All payments must be in the form of a Money Order or Credit Card and must be received before the class date.  Cancellations 24 hours or more prior to class date will receive a full refund less service charges.  Less than 24 hour notice or NO-SHOWS ON CLASS DAY RECEIVE NO REFUND and students will not be allowed to attend another class date in place of the date missed.   There will be a service charge on all refunds of $15 for the flagging classes and $25 for the PEVO classes - Updated November 23rd, 2010.

NOTICE:  A PHOTO I.D. WILL BE REQUIRED AT CLASS

You must call 509-684-7632 in order to reserve the date you wish to attend. Class size is limited to 30 students. Flagging classes may be held in Colville WA, Spokane WA, or another location throughout the state. Please check the schedule page in order to register for the date & location you are seeking OR call for date & location of class. Mark the date in the space above once class location is determined.

Class will start at 8:00am SHARP and run for approximately 7-8 hours. There will be a 30 minute lunch break around 11:30am with numerous breaks throughout. You will be responsible for your own lunch. Please bring a pencil and a highlighter to class.

There will be a written exam at the end of the class which requires a passing grade of 80% or better. Booklets will be provided. Your Flagger Card will be mailed to you the same week. You will not be required to have a photo on your Flagger Card as long as you have some form of photo ID. Photos will be taken after passing the test for those who wish a photo on their card. After you call and confirm your class date you must mail a  Money Order, made out to Northwest Safety Enterprises, along with this completed form to;  1250 N Hwy #275. Colville, WA 99114 - By signing below you accept the terms of this agreement.

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 Student Signature                                                 Date