Workplace Group: Course Registration Form

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Online Registration Form

Use this on-line registration form to register for scheduled courses offered by Workplace Group. The form may be submitted online or you may use our printable registration form and fax or mail it to our office at:

Workplace Group, LLC
420-B Gallimore Dairy Road
Greensboro, North Carolina 27409

(336) 931-0300
FAX (336) 856-2945

You may also register by phone by calling (336) 931-0300.

Payment is due upon registration. Credit cards are accepted for most courses. Please call to pay by credit card or make checks payable to Workplace Group. Payments not received 7 days prior to the course date will result in cancellation of registration.

A letter of confirmation along with directions to the facility will be sent after the registration has been received. See course descriptions for specific class times. Workplace Group reserves the right to cancel any course that does not meet minimum registration requirements.

* Required fields

For more information about our training courses or to register by phone, contact us via or by calling (888) WPG-0001

Course Information:

Please complete course information for each course for which you are registering.

* Course 1 Title:
* Course Dates:
* Location:

Course 2 Title:
Course Dates:
Location:

Course 3 Title:
Course Dates:
Location:

Where did you hear about this course?

* Highlight the source in the list below.

If "other" is selected, please specify

To select more than one source, hold down the "control" key.

Mac users hold down the "command" key.

Personal Information:

* First Name: * Last Name:
Credentials: Other:

* E-mail Address:
Cell Phone:

To select more than one credential, hold down the "control" key.

Mac users hold down the "command" key.

Additional Attendee(s)
2-First Name: Last Name:
Credentials: Other:

E-mail Address:
Cell Phone:

3-First Name: Last Name:
Credentials: Other:

E-mail Address:
Cell Phone:

4-First Name: Last Name:
Credentials: Other:

E-mail Address:
Cell Phone:

5-First Name: Last Name:
Credentials: Other:

E-mail Address:
Cell Phone:

Company Information:

* Company Name:
* Address:
Address 2:
* City:	State:
* ZIP+4:
* Phone:
FAX:

Special Accommodation?:

Please describe below.

Special Instructions:

For courses involving equipment use, such as the hearing conservation and respiratory surveillance courses, please specify your equipment make and model. If you have questions regarding this, please contact Joan Evangelista at (336) 834-8775.

Equipment type:

If you're taking the Workplace Applications Software Training, do you consider yourself a:

New User:

Intermediate User:

Advanced User:

What area(s) are you interested in?

Audio:

Pulmonary:

Health & Safety:

FMLA:

Comments or Questions:



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Return to course listing

Download printable registration form

Privacy policy

Online Registration Form

Where did you hear about this course?

If "other" is selected, please specify