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COURSE REGISTRATION FORM COURSE REGISTRATION FORM

COURSE REGISTRATION FORM - PDF document

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COURSE REGISTRATION FORM - PPT Presentation

2021MnDOT Construcon Engineer Bridge Overview CEBOCourse DescriponThis is an overview course designed for project engineers and engineering specialists with limited experience in bridges Who should at ID: 863771

ons company check bridge company ons bridge check online wark project email overview shannon mndot construction time rma

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1 COURSE REGISTRATION FORM | 202 1 Mn
COURSE REGISTRATION FORM | 202 1 MnDOT Construc�on Engineer Bridge Overview (CEBO) Course Descrip�on This is an overview course designed for project engineers and engineering specialists with limited experience in bridges Who should atend Current Construction Project Managers (Project Engineers and Engineering Specialists) peakers discuss a variety of issues that surround key topics, and use visual presenta�ons deliver live online via zoom COURSE SELECT One Session A and One Session DATE S Below : LOCATIONS COURSE TIME COURSE COST MnDOT Construction Engineer Bridge Overview February 1 6 - , 202 Online via Zoom 8:00 am – 4:30 pm heck in Time is 7:30am $ 4 5 .00 NOTE: Once registered, you should receive an immediate email confirma�on. If you do not receive an email confirma�on,please contact Shannon Wark at shannon.wark@lsc.edu or 2187337680. Company Informa�on Company hone ______________________________Company Email __________________________ Course Par�cipants Personal Informa�on Firstname ______________________Middlename___________________Lastname______________MnDOT Tech ID___________________________________________________________________________________Birthdate____________________________ Last 4 digits Social Security#__________________________________Home address___________________________________________________________________________________Home ity________________________ Home tate____________________Home ____________________Personal ell hone_________________________________ ome Phone________________________________Personal mail___________________________________________________________________________________Have you registered at LSC Before? __ No, Yes; If Yes Provide Student ID#____________________________Birthdate ____________________________ Last 4 digits Social Security# ____________________________ Race and Ethic Background Gender Check or circle any that apply below Check or circle below __ American Indian Alaska Na�ve ,__ Asian , Black or African American , Hispanic or La�n

2 oWhite, or __ Unknown __ Male Female R
oWhite, or __ Unknown __ Male Female Registra�on and Payment Op�ons Register and pay online with credit/debit card. Call 2187337680 to register and pay with a credit/debit card over the phone.Purchase Order/Check PaymentYou will be required to upload a PDF copy of a Purchase Order in order to check out.If you'd like to pay with a PO/check and are not seeing the op�on to do so, please contact ShannonWark at shannon.wark@lsc.edu or 2187337680 to verify you are authorized.All pay later op�ons must be paid within 30 days of the registra�on date.Please note this registra�on system works best when using Chrome. COURSE REGISTRATION FORM | 202 1 MnDOT Construc�on Engineer Bridge Overview (CEBO) CourseDescrip�one online comple�on of this c t atendees should h a b knunderstandingtyles of bridges.Func�ons of bridge components.Bridge construc�on specifica�ons and contract documents.Types of founda�ons and basics of pile driving procedures.Construc�on of substructures and superstructures.Bridge rehabilita�on projects.Environmental concerns.Personnel safety. Who should atend Current Construction Project Managers (Project Engineers and Engineering Specialists) Speakers discuss a variety of issues that surround key topics, and use visual presenta�ons deliver live online via zoom COURSE SELECT One Session A and One Session COURSE BY CHECKING DATE S Below : LOCATIONS COURSE TIME COURSE COST MnDOT Construction Engineer Bridge Overview February 1 6 - , 202 Online via Zoom 8:00 am – 4:30 pm Check in Time is 7:30am $ 4 5 .00 NOTE: Once registered, you should receive an immediate email confirma�on. If you do not receive an email confirma�on,please contact Shannon Wark at shannon.wark@lsc.edu or 2187337680. Company Informa�on Company ame_____________________________________________________________________________________ Company ddress___________________________________________________________________________________Company City______________________ Company State__________________Company Z_______________