Iowa Propane Gas Association
Basic Principles & Practices (CETP) – 2015
Registration Form
Date: Location: Phone:
(Check the date you want to attend)
____ January 26 & 27 IPGA - 1400 Metro East Drive, Pleasant Hill 515-564-1260
____ February 16 & 17 IPGA - 1400 Metro East Drive, Pleasant Hill 515-564-1260
____ July 20 & 21 Dealers LP Equipment – 8645 Northwest Blvd, Davenport 563-386-3874
____ October 19 & 20 Stoney Creek Inn – 300 3rd St, Sioux City 712-234-1100
____ November 9 & 10 IPGA - 1400 Metro East Drive, Pleasant Hill 515-564-1260
Class Times:
Registration begins at 9:30 am on January 26, February 16, July 20, October 19 & November 9 with class starting at 10:00 am.
On January 27, February 17, July 21, October 20 & November 10 class will begin at 8:00 am.
***Please notify attendees of the time difference***
Class ends approximately at 5:00 PM or when test is completed.
Class Fee: Iowa Marketers: $75.00 ____ Non-Marketers: $150.00 ____
Total Paid $ ______
(Sorry we do not accept credit cards)
The Basic class includes a NFPA 58 & NFPA 54 funded by IowaPERC.
Please remit payment to: IPGA - PO Box 57188 - Des Moines, IA 50317
Attendee Name: ______
Company: ______
Billing Address: ______
City, State & Zip Code: ______
Phone: (____) ______Fax: (____)______
(Please print information clearly.)
Hotels available in the Pleasant Hill/Altoona area: Sleep Inn - 5850 Morning Star Ct-Pleasant Hill, IA 50327 (515-299-9922) – Prairie Meadows Hotel - 1 Prairie Meadows Dr.-Altoona, IA 50009 (515-957-3000) – Holiday Inn Express - 165 Adventureland Dr.-Altoona, IA 50009 (515-967-1855) Davenport Area: Comfort Inn-8300 Northwest Blvd, Davenport IA 52806 (563-324-8300) Stoney Creek Inn number listed above. – There are other hotels available. You are responsible for making your own reservations and payment.
Instructions to Registrants:
1. Registration fees include refreshments, lunch, administration fee and class materials.
2. All fees listed are per person.
3. Payment must be received with registration forms. Registration is required.
4. Fees are non-refundable without prior cancellation notice.
5. A NFPA Pamphlet 58 & NFPA Pamphlet 54 will be given to each participant.
*Prior to any test, the instructor must see a Photo ID & Social Security Number (not the card) must be provided.
Registrations must be received at the IPGA office no later than one week prior to class to guarantee class and lunch numbers. Classes with less than 10 attendees may be subject to cancellation. Confirmation of registration and class information will be faxed or mailed prior to class. – Please call IPGA at 515-564-1260 with any questions.
Class partially funded by IowaPERC.