Application form


                                              S&S Training, Inc.
                                    410-852-7093    410-491-5494
                                               Fax  1-717-235-5995

                         APPLICATION  FOR  GAS  FITTERS  CLASS
                                         Registrants Information
                                               (Please Print)


Name____________________________________________________________________________         
                         First                                                      Last                                                         MI

Address___________________________________________________________________________      
                                                                                
City_________________________________________State________ Zip Code _________________        
             
Home Telephone #___________________________Work Telephone #_________________________        
                     
Company Name_____________________________________________________________________       
                                                                           
CompanyAddress___________________________________________________________________

                                  COURSES AND FEES
                                  (Please Check One)

Journeyman Gas Fitter   $400.00 _______ Date of Class  _____________________________        
 Master Gas Fitter           $400.00 _______ Date of Class _____________________________

Note: The 2 PSIG System and the Venting Class are included in both the Journeyman and Master Gas Fitter Classes.

__________________________________________________________________________________________________       
                                                                                  

                         INDIVIDUAL CLASSES, ONE NIGHT ONLY
2 PSIG System                     $125.00_____________________ Date of Class_____________________      
Venting                                $125.00_____________________ Date of Class_____________________  
Intro. to Natural Gas             $  50.00_____________________ Date of Class_____________________
Carbon Monoxide                 $  50.00_____________________ Date of Class_____________________      
Applicants Signature  x _______________________________

Date: x______________                        

Classes are being held at the                                      Please make check payable to:                         
following location at 5:30pm - 8:30pm:                          S&S Training, Inc.                                  
St.John's Catholic Church                                              
Knights of Columbus Hall                                               Mail to:
13305 Long Green Pike                                                 S&S Training, Inc.
Hydes, MD 21082                                                          PO Box 397
                                                                                    Kingsville, Md 21087             
Print as many copies of this page as you need.
The completed form can be:
faxed to: 1-717-235-5995
mailed to: S&S Training, Inc.
PO Box 397
Kingsville, MD 21087