To register for a re-certification course
1. print this page
2. fill out the form
3. fax the form back to the CTTP office
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Center for Training Transportation Professionals
Technician Recertification Program Registration Form |
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CTTP Fax (479-575-7639)
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All classes will be held at the University of Arkansas Engineering Research Center in Fayetteville, AR. Class size is limited to 20 students. Tuition is $475.00 per class per attendee for non-Arkansas State Highway and Transportation Department Personnel. Do not send payment with application; direction on payment and other administrative details will be provided upon confirmation of class assignment. |
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Name: _________________________________________ SSN: ____________________ Title: ____________________________________________________________________ Company Name: ___________________________________________________________ Street/Mailing Address: ______________________________________________________ City: ______________________________ State: _______________ Zip Code: _________ Telephone: ____________________ Fax: ___________________ Email: _______________ Company Contact Person: ____________________________________________________ Contact Number: ______________________________ Current CTTP ID Number: _______________________ |
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TECHNICIAN
RE-CERTIFICATION
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