National Swimming Pool Course Registration

Business*
Business Contact*
First Last
Business Phone*
Business Contact Email*
Billing Address*
Street Address Address Line 2 City Province Postal Code
Participants Name*
First Last
Participants Phone*
Participants Email*
Please choose your preference for training*
- In Classroom
- Online (must attend class on April 5th to write exam)
Pool Course Registration Fee
Price: $ 747.50 CAD Quantity:
($650.00 + $97.50 HST)
Payment Option*
- Credit Card
- E-Transfer: payment@tiapei.pe.ca
- Cash/Cheque (must be received prior to start date)
Credit Card

American Express
Discover
MasterCard
Visa
Card Number Expiration Date Security Code Cardholder Name