Food Safety Sign-Up Form

Food Safety Registration and Payment

GFI Food Safety & Management Certifications

BOOK - Two books in one - KISS Food Safety Manual and HACCP Implementation Manual, published by Pearson Education.
Web Based Training - Done on your computer, about 4 hours for HACCP and 8 hours for Food Safety.
Which Program:
FOOD SAFETY - Certified Professional Food Manager (CPFM) - Web Based Training, Food Safety Book, Test, Certificate upon passing - $229
_______________________________________
HACCP - Certified HACCP Professional CHP - 1 HACCP and 1 Food Safety book bound together, Web Based Training, Test, Certificate and Lapel Pin upon passing - $399
_______________________________________
Master Certified Foodservice Professional Certification - Master Certified Foodservice Professional, Certified Foodservice Professional or Certified Foodservice Supervisor. We suggest you get the book, study, and THEN decide which one you want to take - $159

Estimated Date
you plan to test

Candidate's First Name

Middle initial

Last name

Title

Company

Street address

Address (cont.)

City

State

Zip Code

Address is: Work or Home

Work Phone

Home Phone

Preferred Contact Phone:

Work or Home

FAX

E-mail

Are you IFSEA certified? Yes No

Proctor Name Will supervise the exam.

Proctor E-Mail

Proctor Phone

Proctor's Job Title Cannot be in hospitality field

Proctor Street address

Proctor Address (cont.)

Proctor City

Proctor State

Proctor Zip Code

Questions or Comments?

Payment By: Charge Navy Voucher Check to follow Purchase order

Card Number:

Expiration:

*Don't forget to give us your Charge Card Number if paying by charge!
Visa, Master Card, AMEX only please!
Discover Card OK but you must call in the number to 702-430-9217.
Charges for food safety programs processed by E. H. Manley & Associates, Inc.

You can also make secure on-line payments with PayPal -
it's fast, easy, secure and holds our costs down!
Click on the logo! The link will verify win@workaholic.org, the registered e-mail for EHMA.

Purchase Order #:

Thank you for your interest in the GFI FoodSafety program!

You might want to print this, before submitting, for your records or for reimbursement! If we have your e-mail address you should get an acknowledgement from us in 72 hours. If you don't, please contact us!

Back to IFSEA Main Page

2609 Surfwood Drive
Las Vegas, NV 89128
Phone: 702-430-9217
Fax: 702-430-9223
E-Mail: Ed@ehmanley.com

BOOK - Two books in one - KISS Food Safety Manual and HACCP Implementation Manual, published by Pearson Education. Web Based Training - Done on your computer, about 4 hours for HACCP and 8 hours for Food Safety.	Which Program: FOOD SAFETY - Certified Professional Food Manager (CPFM) - Web Based Training, Food Safety Book, Test, Certificate upon passing - $229 _______________________________________ HACCP - Certified HACCP Professional CHP - 1 HACCP and 1 Food Safety book bound together, Web Based Training, Test, Certificate and Lapel Pin upon passing - $399 _______________________________________ Master Certified Foodservice Professional Certification - Master Certified Foodservice Professional, Certified Foodservice Professional or Certified Foodservice Supervisor. We suggest you get the book, study, and THEN decide which one you want to take - $159
Estimated Date you plan to test
Candidate's First Name
Middle initial
Last name
Title
Company
Street address
Address (cont.)
City
State
Zip Code
Address is:	Work or Home
Work Phone
Home Phone
Preferred Contact Phone:	Work or Home
FAX
E-mail
Are you IFSEA certified?	Yes No

Proctor Name	Will supervise the exam.
Proctor E-Mail
Proctor Phone
Proctor's Job Title	Cannot be in hospitality field
Proctor Street address
Proctor Address (cont.)
Proctor City
Proctor State
Proctor Zip Code
Questions or Comments?

Payment By:	Charge Navy Voucher Check to follow Purchase order
Card Number:
Expiration:
*Don't forget to give us your Charge Card Number if paying by charge! Visa, Master Card, AMEX only please! Discover Card OK but you must call in the number to 702-430-9217. Charges for food safety programs processed by E. H. Manley & Associates, Inc.
You can also make secure on-line payments with PayPal - it's fast, easy, secure and holds our costs down! Click on the logo! The link will verify win@workaholic.org, the registered e-mail for EHMA.

Purchase Order #: