Electrofishing Principles and Safety Certification Course Sign-up

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

Course participants are expected to provide the following:

Lineman gloves
Non-breathable chest waders and associated footwear
Note taking materials
Optional: polarized sunglasses and rain gear

Your Information

Name

Organization

Street Address

City

State

Zip Code

Country

Telephone

Course Attendance Date

Course Date

Payment Information

The class at our Vancouver headquarters costs $500 per student or is included at no cost with the purchase of any new Smith-Root backpack electrofisher. Courses held at other locations will have different costs.

Payment Options

Credit CardCourse VoucherPurchase Order

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 Electrofishing Course Agreement and Liability Release. Participants are also required to sign the Liability Release on day of class.