Enrollment Form | Accurate Environmental

IMPORTANT: Enrolling in a class does not automatically register you for the associated certification exam. Anyone wishing to take an ODEQ certification exam must also apply for the exam through the online ODEQ Operator Certification Portal (https://okdeq.my.site.com/s/) at least 21 days before the class start date.

Student Name

Title / Position

Business Name

Business Street Address

City

State/Province

Zip / Country Code

Office Phone

Student Email

Student Mobile Phone

May we use the phone/email to send class reminders?

Yes

Certification Classes

Renewal Classes

Class Date(s)

How will you be paying?

Certification classes: $150/day (8 hrs); Renewal classes: $75/half-day (4 hrs)

Questions/Comments (*Use this space to list the billing contact person and email)