PrimaTech Training Institute 2014

INTERNATIONAL TRAINING REGISTRATION FORM / VISIT WWW.PRIMATECH.COM/TRAINING FOR COMPLETE LISTING OF COURSES
COURSES:

PLEASE RETURN COMPLETED FORM WITH PAYMENT TO:

Process Hazard Analysis (P HA) for Team Leaders 5 days

PTI Course Coordinator

Prim atech I nc.
50 N orthw oods Boulevard
Colum bus, Ohio 432 35 (USA )

April 14-18, Calgary, AB, Canada $3,095

May 12-16, Amsterdam, Netherlands 3,690, 3,100
July 21-25, Mexico City, Mexico $3,095
August 18-22, Toronto, ON, Canada $3,095
November 3-7, Brussels, Belgium 3,690, 3,100
December 8-12, Singapore, Singapore $4,795

Please Circle: Dr. Mr. Miss Mrs. Ms. / First Name:

Last Name:
Title:
Company:

Layers of Protection Analysis (LOP A) for Process Safety

M anagem ent (PSM ) 3 days

May 5-7, Amsterdam, Netherlands 1,840, 1,550

November 10-12, Brussels, Belgium 1,840, 1,550
December 15-17, Singapore, Singapore $2,395

Fax:
Email:

May 8, Amsterdam, Netherlands 770, 650

November 13, Brussels, Belgium 770, 650
December 18, Singapore, Singapore $995

TERMS (REQUIRED): Course fees are due prior to the course dates. A 25% cancellation fee will
be charged for cancellations less than four (4) weeks prior to the course start date. No refunds can be
given for cancellations less than two (2) weeks prior to the course start date, although substitutions are
allowed. Registration fees include course materials, coffee breaks, lunches, and a course certificate.
Registration fees do not include computer rentals for software courses. Attendees are responsible for
providing their own computers for software courses. Hotel, travel and other related expenses are the
participant's responsibility. Hotel information and travel directions will be provided to registrants. Please
let us know in advance if you have any special access or dietary needs. Primatech reserves the right to
change course dates, course locations, course fees, and course content at its sole discretion without
notice.

May 9, Amsterdam, Netherlands 770, 650

November 14, Brussels, Belgium 770, 650
December 19, Singapore, Singapore $995

Using LOPAW orks Softw are 1 day

Address:

Mobile:

Risk Tolerance Criteria for Process Safety 1 day

Address:

Phone:

SI L Determ ination Using LOPA and Other M ethods 1 day

Phone: 614 -841-98 00

Fax : 614-841 -9805
Em ail: training@prim atech.com
w w w .prim atech.com

May 12, Amsterdam, Netherlands 770, 650

November 17, Brussels, Belgium 770, 650
December 22, Singapore, Singapore $980

I agree to the Terms: detailed above. Signature required for enrollment.

PREFERRED PAYMENT OPTION:

Credit Card*: We accept American Express, MasterCard, Visa, and Discover

(please circle type). To process any order, the following information is required:
Credit card number:
Expiration date:

DISCOUNTS

Name as it appears on the card:

Prim atech reserves the right to chan ge and/ or end the discounts at any tim e. Offer
valid for courses attended during and after January 1, 2014. N ote: lim ited to one
discount per registration.

For MasterCard, Visa, or Discover - Card Verification Value (CVV2), three-digit code
located on the back of the card:

Three or four employees from the same company attending the same international
course at the same time will receive a 10% discount off the total price.

For American Express - Unique Card Code (CID), four-digit code located above and to
the right of the credit card number:

Five or more employees from the same company attending the same international
course at the same time will receive a 15% discount off the total price.

Billing address of the credit card (address to where the statement is sent):

Take any two courses during the same week and receive 185 Euros, 155 GBP, or $250
USD off the total price.

Name:

Attend the full 5-day week LOPA PTI Series (LOPA, SIL Determination, and Risk Tolerance
Criteria) and receive LOPAWorks for $2000 USD plus a free optional LOPAWorks training
webinar.

Address:

Company (if required):

Address:
*Note: All credit card charges will be made in U.S. dollars using the published conversion rate on the date

of the transaction.

OTHER PAYMENT OPTIONS (Course fees are due prior to the course dates):

Wire Transfer: Please contact Primatech for wire transfer information.

Check: Please see above for mailing information.

REGISTERING: Course attendance is limited, and classes are filled on a first-come first-served basis. We recommend registering at least four weeks prior to course date.

TRAINING / SOFTWARE PROMOTIONS

Prim atech reserves the right to chan ge and/ or end the prom otions at any tim e. Offers valid for courses attended during and after January, 2014.

Mexico City US Dollars:

Attend Process Hazard Analysis (PHA) for Team Leaders for $3,095 and you can purchase
PHAWorks for $1,000 ($2,000 savings) and/or Tracker for $5,000 ($1,000 savings).

Attend Layers of Protection Analysis (LOPA) for Process Safety Management (PSM) for
$2,395 and you can purchase LOPAWorks for $3,000 ($3,000 savings).

Dubai US Dollars:

Amsterdam, Brussels Euros, Pounds Sterling:

Attend Process Hazard Analysis (PHA) for Team Leaders for 3,690 and you can purchase
PHAWorks for 770 (1,540 savings) and/or Tracker for 3,860 (770 savings).

Attend Layers of Protection Analysis (LOPA) for Process Safety Management (PSM) for 1,840
and you can purchase LOPAWorks for 3,085 (770 savings).

Singapore, Shanghai US Dollars:

Attend Process Hazard Analysis (PHA) for Team Leaders for $4,795 and you can purchase
PHAWorks for $1,000 ($2,000 savings) and/or Tracker for $5,000 ($1,000 savings).

Attend Process Hazard Analysis (PHA) for Team Leaders for $4,795 and you can purchase
PHAWorks for $1,000 ($2,000 savings) and/or Tracker for $5,000 ($1,000 savings).

Attend Layers of Protection Analysis (LOPA) for Process Safety Management (PSM) for
$2,395 and you can purchase LOPAWorks for $3,000 ($3,000 savings).

Attend Layers of Protection Analysis (LOPA) for Process Safety Management (PSM) for $2,395
and you can purchase LOPAWorks for $3,000 ($3,000 savings).

2014_international_training_registration_and_prices_2014-09-29