Application
Medical Gas Inspector
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| City, State, Zip Code | |
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| Company Name | |
| Company Address | |
| City, State, Zip Code | |
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Date(s) of Class Training____________________________.
I am applying for the above-mentioned Medical Gas Inspector Course. I have a minimum of two (2) years documented practical experience and I can prove that I meet one of the following.
Candidate shall be employed by a governmental unit as a plumbing, mechanical, or combination inspector or is employed by a governmental unit as an administrator of such inspectors, or is a registered / licensed professional engineer or is employed by an engineering firm that designs medical gas systems.The cost of the class MUST be received within 3(three) days of application. There will be NO changes or cancellations accepted within two weeks of class start date. No Refunds will be given within two weeks of class start date. A minimum of 10(ten) students is required to have a class. If the 10-student minimum is not met, all fees will be returned.
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Signature of Applicant Date
Please fax this application to (623) 434-0230
Or mail to 1831 W Rose GardenLane. Phoenix, AZ 85027
