<p> Office Use Only 0001-542-7529 Company Name UST REMOVER TRAINING & EXAM Name of Attendee REGISTRATION FORM May 20, 2016 8:00 am – 5:00 pm</p><p>Please register by May 10, 2016, to secure your space at the training. The registration fee is $50 per person for the instructor training guide and exam (lunch on your own). A non-refundable check or money order payable to ‘Iowa Department of Natural Resources’ must accompany each application.</p><p>FOR REMOVER LICENSE APPLICANTS: Name: Company: Address City State: Zip: Phone: Email: </p><p>FOR LICENSED REMOVERS (NO FEE FOR CEUS): Name: Company: Address City State: Zip: Phone: Email: Note: The Iowa Department of Natural Resources Underground Storage Tank Section accredited this program for 12 hours of continuing education credits for renewal certification. </p><p>Please submit registration form and check Training & Exam or money order to: Location: Bonnie Garrison Adventureland Inn Iowa Dept of Natural Resources Iowa Ballroom Underground Storage Tank Section 3200 Adventureland Dr 502 E. 9th Street Hwy I-80 (Exit 142A) Des Moines, IA 50319 Altoona, Iowa</p><p>Phone: 515-725-8310 E-Mail: [email protected]</p>