REGISTRATION INFORMATION:

  • Fill out the form below with name, address, etc.
  • Indicate the type of class you are interested in.
  • Indicate the desired class date. DO NOT REGISTER FOR A CLASS MARKED “FULL”
  • Backflow testers recertifying: Indicate your current certification if re-certifying.
  • FOR NEW CERTIFICATION: Prerequisite: ASSE requirements for those taking the class are that: “a student has demonstrated at least five years of experience in a plumbing, pipefitting or a related industry field…” Experience in lawn irrigation is acceptable.  STUDENTS MUST EXPLAIN THEIR EXPERIENCE IN THE “COMMENTS” SECTION ON THE REGISTRATION FORM.

NOTE:  your enrollment is not final until payment is received.

Since classes fill up quickly it is a good idea to pay by credit card or mail a check within several days of registering. If payment is made by credit card, it will be confirmed by email within 24-hours of receipt.

Fees must be received no later than six weeks prior to class. Classes may fill up earlier than this deadline. Registration is not complete until payment has been received by the school.

If paying by check

Indicate your choice of paying by check, and click “submit.”

Make checks payable to: KCBACKFLOWSTL

Mail checks to: Aqua Services P.O.Box 69, Cottleville, MO 63338-0069.

If paying by credit card:

If paying by credit card, fill out and submit a registration form and indicate you want to pay by credit card.  We will email you a PayPal invoice.

NOTE:  YOU MUST PROVIDE A VALID EMAIL ADDRESS ON YOUR REGISTRATION AND PAYMENT FORM WHERE YOU CAN RECEIVE A PAYPAL INVOICE FOR YOUR CREDIT CARD PAYMENT.

Registration

    Your Name (required)

    Your Email (required)

    Your Address

    City

    State

    Zip

    Phone (Daytime) with Area Code

    Phone (Evening) with Area Code

    Desired Class Date (Please enter in month/day/year format)

    Certification Type:

    New CertificationRe-CertificationCEU

    Current Certification:

    Comments Or Questions:

    Payment Type:

    CheckCredit CardPurchase Order