Fill out this form and submit it to sign up for the Workshop in Nome on June 1 & 2, 2012. All fields are required. If you have nothing to put in one of the fields, just enter "NA".

Please complete a separate form for each person registering.

If you have questions or prefer to register by phone, please call AMSEA at 907-747-3287.

Please register me for the following:

Safety Workshop for Nome Divers and Dredgers - June 1-2 - FREE

You will be contacted by the instructor before the workshop begins, with information about schedule, location, what to bring, etc.

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To help us promote similar classes in the future, please let us know how you heard about this class. Check as many as apply.

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