2025 Apprentice Lineworker ProgramPage 1 of 4Company InformationCompany Name*Registration Fee*Please selectNEPPA Member $3,750Non Member $5,650Number of Registrants*Please select12345NextSupervisor Contact InformtionSupervisor Name*FirstLastSupervisor Email*Supervisor Title*Supervisor Phone*BackNextRegistrant InformationRegistrant 1 Enroll in Class Year*Year 1Year 2Year 3Year 4Registrant 1 Shipping Address *Shipping address required for timely delivery of student manuals in advance of the first day of classes.Registrant 1 Name (Legal Name for Certificate)*Registrant 1 Title *Registrant 1 E-mail*Registrant 1 Phone*Registrant 1 T-Shirt/ Sweatshirt Size (One Only)*SmallMediumLargeXL2XL3XLDietary or other restrictions (if none put N/A)*Registrant 2 Enroll in Class YearYear 1Year 2Year 3Year 4Registrant 2 Shipping Address *Shipping address required for timely delivery of student manuals in advance of the first day of classes.Registrant 2 Name (Legal Name for Certificate)Registrant 2 Title Registrant 2 E-mailRegistrant 2 PhoneRegistrant 2 T-Shirt/ Sweatshirt Size (One Only)SmallMediumLargeXL2XL3XLDietary or other restrictions (If none put N/A)Registrant 3 Enroll in Class YearYear 1Year 2Year 3Year 4Registrant 3 Shipping Address *Shipping address required for timely delivery of student manuals in advance of the first day of classes.Registrant 3 Name (Legal Name for Certificate)Registrant 3 Title Registrant 3 E-mailRegistrant 3 PhoneRegistrant 3 T-Shirt/ Sweatshirt Size (One Only)SmallMediumLargeXL2XL3XLDietary or other restrictions (If none put N/A)Registrant 4 Enroll in Class YearYear 1Year 2Year 3Year 4Registrant 4 Shipping Address *Shipping address required for timely delivery of student manuals in advance of the first day of classes.Registrant 4 Name (Legal Name for Certificate)Registrant 4 Title Registrant 4 E-mailRegistrant 4 PhoneRegistrant 4 T-Shirt/ Sweatshirt Size (Select only one)SmallMediumLargeXL2XL3XLDietary or other restrictions (if none put N/A)Registrant 5 Enroll in Class YearYear 1Year 2Year 3Year 4Registrant 5 Shipping Address *Shipping address required for timely delivery of student manuals in advance of the first day of classes.Registrant 5 Name (Legal Name for Certificate)Registrant 5 Title Registrant 5 E-mailRegistrant 5 PhoneRegistrant 5 T-Shirt/ Sweatshirt Size (select only one)SmallMediumLargeXL2XL3XLDietary or other restrictions (if none put N/A)Other Notes or Instructions for RegistrationBackNextCANCELLATION POLICY & PAYMENT AGREEMENT* To submit this registration, please read and check the box below to confirm that you agree to the following “Cancellation Policy and Payment Agreement”. By checking the box below, you confirm that you agree to the “per person” cost of the selected program and acknowledge that if the event is cancelled NEPPA will credit any payment made, either in full or pro-rated, depending upon the program. Please note: There will be a make-up administration fee applied for each session, per student. Cancellation Policy: All program withdrawals must be sent in writing to NEPPA or emailed to training@neppa.org with attention to Colleen Del Signore. Substitutions may be made at any time (prior to the start of the program). Books must be returned within 35 days of the shipment date, provided that no exams have been taken and they are in like-new condition, so the appropriate refund can be issued. If books are not returned within this time frame, the cost will be deducted from the tuition refund as described below. Withdrawals/cancellations received based on the schedule below are eligible for the following: 3 weeks prior to the 1st scheduled week of class = 100% refund of tuition Before completion of the 1st scheduled week of class = 75% refund of tuition Before the completion of the 2nd scheduled week of class = 50% refund of tuition After the 2nd scheduled week of class = 0% refund of tuition NEPPA takes photographs during its meetings and events for use in association advertising, newsletters and other promotional materials, whether in print, electronic or other media, including the NEPPA website. By participating in this event I authorize NEPPA the right to use my name and photograph for such purposes. I agree to the above Terms and Conditions *Yes, I agreePlease type the characters*This helps us prevent spam, thank you.BackSendThis field should be left blank