Registration Form

PHMSA - U.S. Department of Transportation - Pipeline and Hazardous Materials Safety Administration

Hazmat Registration Form

Please use this form to register for Multimodal Training Seminars or Hazmat Transportation Workshops. Each seminar begins with a General Session that provides overviews of the Department of Transportation's Hazardous Materials Program, and what to expect during the seminar. The remainder of the two-day seminar consists of Concurrent Breakout Sessions. Workshops provide a basic overview of the regulatory requirements — what they are, how they apply, and how to meet them - for shipping and transporting Hazardous Materials. Please \ review the information and schedules to review available dates and locations.

* Indicates a required field.

Name:*
Agency/Company:
Email:
Street Address:*
City:*
State:*
Zip Code:*
Phone Number:*
Fax Number:
Workshop or Seminar?:*	One-Day Workshop Two-Day Seminar
Date of Desired Workshop or Seminar:*
Location of Desired Workshop or Seminar:*
Additional Information, Comments or Requests:
Note: If more than one person will attend from your organization, please submit a copy of this form for each attendee. If you have difficulties with this form or need more information, call 202-366-4900 or email phmsa.hm-seminars@dot.gov.