SERVSAFE® FOOD SAFETY SANITATION & SAFETY MANAGERS TRAINING & EXAM REGISTRATION

To register for our upcoming ServSafe® Food Safety Sanitation and Safety Managers Training and Exam course, please complete the form below. Questions? Please call (856) 422-3872 or email info@dvsconline.org

Name*
First Last
Company Name*
Address*
Street Address Address Line 2 City State ZIP Code
Contact Email*
Fax
Phone*
Extension
I am taking*
Training Date*
Number attending:
Test Date*
Number testing:
1st Student Name
1st Student Email
2nd Student Name
2nd Student Email
Number testing
Please select your language:*
(For your textbook and exam)
How will you be paying for training?*
Payment by Credit Card:
Type of Card
- American Express
- Mastercard
- Visa
- Discover
Card Number

xxxx-xxxx-xxxx-xxxx
Exp. Date

mm/yy
Security Code
Name as it appears on card
Credit Card Billing Address
Street Address Address Line 2 City State ZIP Code
Signature of Card Holder
Payment by Purchase Order
Purchase Order Number
How to did you hear about this training?*
If other, please specify
Total Course Cost:
$0.00

TERMS AND CONDITIONS:

COURSE FEES:
Enrollment is not guaranteed until full payment is received. You will be placed on a waiting list if your registration form does not include payment.

METHOD OF PAYMENT:
Payment shall be made in one of the following methods:

1. Credit Card (American Express, MasterCard, VISA)
2. Purchase Order (copy must accompany registration form)

PLEASE NOTE:
A 3% convenience fee will be charged on all credit card transactions.

NOTIFICATION FOR CANCELLATION OR CHANGES:
Customer shall have the right to cancel enrollment, with or without cause, up to 24 hours prior to the training date to receive a 100% refund. Failure to notify DVSC before the 24-hour period will result in a forfeiture of payment.

Our Partners

CONTACT DVSC

510 Heron Drive

Suite 210

Swedesboro, NJ 08085;

Main Line: 856.422.3872 (DVSC)

Email: info@dvsconline.org

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