Client

Name:
Address:
Phone #1:
Phone #2:
Email:
Contact Name :
Contact Phone #:
Alternate Contact:
Alternate Contact Phone #:

Course:

Course	Dates (First Choice)		Dates (Second Choice)
3 Day Intermediate Faller
2 Day Basic Bucker
1 Day Awareness

Students:

• Maximum of 8 per course
• Students requiring recertification must provide a WTA certificate issued within 3 years of the upcoming recertification date
• Students under the age of 18 must have parent or guardian co-sign waiver/consent form at beginning of course

PPE Supplied

• group first aid kit
• high-vis vest
• chainsaw safety chaps (cUL/BNQ or WCB-BC PPE1-1997 approved with a TSS of 3900).
• orange hard hat, CSA or ANSI-Z89 approved, with wire mesh screen and ear muffs with 24 NRR
• Saskatchewan OHS approved personal first aid kit (SK1)
• whistle with safety pin

PPE Students Must Bring*:

• CSA approved chainsaw boots (Green Tree). I have boots available but in limited sizes.
• work gloves
• appropriate clothing, sun screen, bug dope

* contact Christopherson Industrial Supplies in Prince Albert (306) 764-2102

Location

Classroom Size	Field Site
Address:	Location:
Directions:	Directions:
Room #:	Tree Height:
	Tree Diameter:
	Land Owner
	Access:

Rates

Basic rate for instruction:
	3 day Intermediate Course (min 5, max 8 students)	$425/student
	2 day Basic Course (min 5, max 8 students)	$300/student
	1 day Awareness Course (min 5, max 8 students)	$200/student
	Recertification	$200/student
WTA Registration & Manual:		$50/student
Travel return from Christopher Lake, SK:		$0.65/km**
Travel on Saskatchewan highways 905, 914 & 955:		$0.85/km**
Travel on Athabasca Seasonal Road, #155* and other winter roads		$1.50/km**
Meals during course, travel & set-up:		$50/day**
Accommodation during course, travel & set-up:		as billed
Additional, site-specific expenses (e.g., permits)		as billed
* minimum 7 students for for northern communities
** or applicable government rate

Payment

• Invoice for full amount will be issued upon completion of course.
• Payment due 30 days from invoice date.
• Late payments subject to 2% per month late fee.
• Payment by cash, cheque or money order.
• Fees subject to GST (#859 413 544 RT 0001) & PST (# 197 2447) unless exemption exists.
• Deposit not required.
• Temporary 60 day certificates issued at end of course; 3-year certificates issued upon payment in full.

Confirmation

I have read and agree to the above policies and rates.
 

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Name                                           Signature                                       Date