Electrofishing Principles and Safety Certification Course Registration

Use this form to register for the Electrofishing Principles and Safety Certification course hosted and taught by Smith-Root.

Your information

Name

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Organization

Street Address

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City

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State

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Zip/Postal Code

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Country

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Telephone

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Please enter your email address.

Course attendance date

Course

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Payment information

The class cost is $500 per student or is included at no cost with the purchase of any new Smith-Root backpack electrofisher. A Smith-Root representative will contact you in the coming weeks to collect payment information.

Payment Options

Credit Card

Course Voucher

Purchase Order

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Purchase Order Number

Additional information

These questions are optional, but your answers will assist us in planning a course that meets your needs.

What prompted you to seek training?

What do you hope to learn from the course?

What electrofishing equipment (i.e. make and model) do you generally use?

By submitting this form, participant certifies that the information provided herein is true and accurate and that they have read and agree to the terms and conditions provided in the Liability Release. Participants are also required to sign the Liability Release on day of class.

You'll receive a confirmation email.