{"content":[{"text":"Registration form","bbox":{"left":0.058824,"top":0.088818,"width":0.163337,"height":0.020939}},{"text":"PIPE-FITTING CEU Training Course $100.00 \n 48 HOUR RUSH ORDER PROCESSING FEE ADDITIONAL $50.00 \n Start and Finish Dates: ____________________________________________________ \n You will have 90 days from this date in order to complete this course","bbox":{"left":0.058823,"top":0.143688,"width":0.766588,"height":0.089037}},{"text":"List hours worked on assignment must match State Requirement. ___________________","bbox":{"left":0.058823,"top":0.245682,"width":0.7783770000000001,"height":0.020863999999999994}},{"text":"Name__________________________________Signature_______________________________ \n I have read and understood the disclaimer notice on page 2. Digitally sign XXX","bbox":{"left":0.058823,"top":0.295241,"width":0.781511,"height":0.03162200000000004}},{"text":"Address_________________________________________________________________","bbox":{"left":0.058824,"top":0.3575,"width":0.78722,"height":0.020863999999999994}},{"text":"City__________________________________State_________________Zip___________","bbox":{"left":0.058824,"top":0.409697,"width":0.790371,"height":0.020863999999999994}},{"text":"Email__________________________________ Fax (____) ________________________","bbox":{"left":0.058824,"top":0.46197,"width":0.791409,"height":0.020863999999999994}},{"text":"Phone: \n Home (____) _______________________","bbox":{"left":0.058824,"top":0.496818,"width":0.372763,"height":0.03828799999999999}},{"text":"Work (____) ________________________","bbox":{"left":0.469841,"top":0.514242,"width":0.3781379999999999,"height":0.020863999999999994}},{"text":"Operator ID #_________________________________________Exp. Date____________","bbox":{"left":0.058824,"top":0.566515,"width":0.7914509999999999,"height":0.020863999999999994}},{"text":"Please circle/check which certification you are applying the course CEU’s. \n Water Treatment ___ Water Distribution ___ Other ___________________________","bbox":{"left":0.058824,"top":0.600166,"width":0.70228,"height":0.03488900000000006}},{"text":"Collections ___","bbox":{"left":0.058824,"top":0.647899,"width":0.122819,"height":0.019048999999999983}},{"text":"Wastewater Treatment ____","bbox":{"left":0.196675,"top":0.647899,"width":0.22668100000000002,"height":0.019048999999999983}},{"text":"Technical Learning College \n Toll Free (866) 557-1746","bbox":{"left":0.178922,"top":0.681454,"width":0.233669,"height":0.03507500000000008}},{"text":"TLC PO Box 3060, Chino Valley, AZ 86323 \n Fax (928) 272-0747 info@tlch2o.com","bbox":{"left":0.426068,"top":0.681454,"width":0.358209,"height":0.03507500000000008}},{"text":"If you’ve paid on the Internet, please write your Customer#_________________","bbox":{"left":0.058824,"top":0.730606,"width":0.731096,"height":0.020863999999999994}},{"text":"Please invoice me, my PO#__________________________________________","bbox":{"left":0.058824,"top":0.765455,"width":0.710717,"height":0.020863999999999994}},{"text":"Please pay with your credit card on our website under Bookstore or Buy Now. Or call us \n and provide your credit card information.","bbox":{"left":0.058824,"top":0.800303,"width":0.826093,"height":0.03828799999999999}},{"text":"We will stop mailing the certificate of completion so we need either your fax number or e-mail \n address. We will e-mail the certificate to you, if no e-mail address; we will fax it to you.","bbox":{"left":0.058824,"top":0.85126,"width":0.7981079999999999,"height":0.03514499999999998}}],"images_bbox":[],"images_bbox_not_text_overlap":[]}