Page 1 of 42024 @Your-Site Virtual TrainingCompany Information Company Name*Registration Fee*Please selectNEPPA MemberNon MemberNumber of Registrants*Please select12345NextSupervisor Contact InformtionSupervisor NameFirstLastSupervisor Title*Supervisor Email*Supervisor Phone*BackNext2024 @Your-Site Virtual TrainingParticipant:Participant 1 Name*Participant 1 Title*Participant 1 Email*Participant 1 Phone*Participant 1 (Individual Sessions)*Underground Distribution Review (Wednesday, April 17, 2024)Personal Protective Equipment (Thursday, April 18, 2024) Hot Stick Safety (Wednesday, September 4, 2024)Job Briefings (Thursday, September 5, 2024)Participant 2 NameParticipant 2 TitleParticipant 2 EmailParticipant 2 PhoneParticipant 2 (Individual Sessions)Underground Distribution Review (Wednesday, April 17, 2024)Personal Protective Equipment (Thursday, April 18, 2024)Hot Stick Safety (Wednesday, September 4, 2024) Job Briefings (Thursday, September 5, 2024))Participant 3 NameParticipant 3 TitleParticipant 3 EmailParticipant 3 PhoneParticipant 3 (Individual Sessions)Underground Distribution Review (Wednesday, April 17, 2024) Personal Protection Equipment (Thursday, April 18, 2024)Hot Stick Safety (Wednesday, September 4, 2024)Job Briefings (Thursday, September 5, 2024)Participant 4 NameParticipant 4 TitleParticipant 4 EmailParticipant 4 PhoneParticipant 4 (Individual Sessions)Underground Distribution Review (Wednesday, April 17, 2024)Personal Protective Equipment (Thursday, April 18, 2024)Hot Stick Safety (Wednesday, September 4, 2024)Job Briefings (Thursday, September 5, 2024))Participant 5 NameParticipant 5 TitleParticipant 5 EmailParticipant 5 PhoneParticipant 5 (Individual Sessions)Underground Distribution Review (Wednesday, April 17, 2024) Personal Protective Equipment (Thursday, April 18, 2024)Hot Stick Safety (Thursday, September 5, 2024)Job Briefings (Thursday, September 5, 2024)Other Notes or Instructions for RegistrationBackNext2024 @Your-Site Virtual Training TERMS AND CONDITIONS* In order to submit the registration check the box below to 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. Once the registration has been processed, participants will receive an auto-generated email including unique login credentials to access the session. I agree to the above Terms and Conditions *Yes, I agreeIf you have any questions, please contact training@neppa.org or call the office at (978) 540-2200. Please be sure to check "Yes, I agree" above and print your completed form (see below) prior to clicking the Submit button.Please type the characters*This helps us prevent spam, thank you.BackSendThis field should be left blank