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Portable Nuclear Density Gauge Training

*Required information
*Company Information:
*Company: Four portable gauges
*Contact Person:
*Phone:
*E-mail:
Fax:
*Class Location:  *Class Date: 
Idaho Falls, ID: May 30-(31), 2013:
Mesa, AZ: June 27-(28), 2013:
Round Rock, TX: July 25-(26), 2013:
 Mailing Address:  Billing Address: 
 Check if same as Mailing.
* Name:  * Name: 
* Address:  * Address: 
* City:  * City: 
* State:  * State: 
* Zip Code:  * Zip Code: 
Participants and Class:
Participant Authorized
Gauge User
 (One-Day)
($195)
Radiation
Safety Officer
(Two-Day)
($595)
*Select Payment Option:
Credit Card - Have a Qal-Tek Associates representative call me for Credit Card information.
Check - We will mail a check so that it arrives at
Qal-Tek Associates before the first day of class.
Please notify us of any cancellations seventy-two (72) hours prior to course date.
Without the required notification, the full course fee will be charged.
Questions or Comments:

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