2020 food handler certification program registration form · of government issued photo...

September 18 Simcoe

2020 Food Handler Certification Program Registration Form

REGISTRATION INSTRUCTIONS: Submission of completed form and payment made in-person will reserve your spot in the chosen course/exam. Cheques are to be made payable to ‘Norfolk County’. Please do not mail or email registration forms and/or payment due to limited spots available. Please note we do not accept credit cards. Registration fees are non-refundable one week prior to the course/exam.

The Food Handler Certification Program is taught in English only. Upon request, exams can be provided in French, Chinese (simplified), Spanish, Arabic and Greek. Upon successfully completing the exam, you will receive a Ministry of Health and Long Term Care approved certificate which is valid for five (5) years. The passing mark is 70%. If you are unsuccessful in achieving the minimum mark of 70%, you will be allowed one re-write free of charge. Please bring a piece of Government issued photo identification to the course/exam. Please bring a piece of Government issued photo identification to the course/exam

If you require further assistance, contact the Haldimand-Norfolk Health Unit at 519-426-6170 or 905-318-6623 ext. 3231 or at environmentalhealth@hnhss.ca. Please note: Calendonia is closed for lunch. Caledonia and Dunnville accept cash and cheque only.

Name:

Email Address:

Address:

Postal Code:

Phone Number:

Option A - $54 1 Day Course – 9:30 a.m. to

4:30 p.m. (Tuesdays)

Date Course Location

February 4 Simcoe

February 11 Caledonia

April 21 Simcoe

May 5 Caledonia

June 16 Simcoe

September 15 Simcoe

October 6 Dunnville

November 17 CaledoniaDecember 8 Simcoe

Option B - $25 (Exam Only-Includes Manual)

Time: 9:30-10:30 a.m. (Fridays)

Date Exam Location

January 24 SimcoeMarch 27 SimcoeApril 3 DunnvilleApril 24 Caledonia

May 8 Simcoe

June 5 Simcoe

June 12 Caledonia

Option C - $10

OPTION A (Course) LocationsCaledonia: Caledonia Public Library 2-100 Haddington St.Caledonia, ON N3W 2N4 (Use Arena Entrance)

Dunnville: Grandview Lodge 657 Lock St. W. Dunnville, ON N1A 1V9 Auditorium

Simcoe: Health & Social Services Department 12 Gilbertson Dr. Simcoe, ON N3Y 4N5

OPTION B (Exam) LocationsCaledonia: Caledonia Public Library 2-100 Haddington St.Caledonia, ON N3W 2N4 (Use Arena Entrance)

Dunnville: Health & Social Services Department 117 Forest St. E. Dunnville, ON N1A 1B9

Simcoe: Health & Social Services Department 12 Gilbertson Dr. Simcoe, ON N3Y 4N5

OFFICE USE ONLY

Receipt #

Manual Issued by:

Method of payment

Cash

Updated January 2020

Personal information contained on this form is collected pursuant to the Municipal Freedom of Information and Protection of Privacy Act 1990. Any questions should be directed to the Supervisor, Information and Privacy, Norfolk County, at 519-426-5870 or at recordsfoi@norfolkcounty.ca

City/Town:

SimcoeJuly 10

July 17 CaledoniaSimcoeAugust 14

August 21 Caledonia

CaledoniaNovember 20 DunnvilleSeptember 25

Exam Only - Choose from dates in Option B

(initial)

Cheque Debit Amount:Date:

SimcoeOctober 20

PLEASE PRINT CLEARLY:

DunnvilleJanuary 14

March 10 Dunnville