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MSI LIVE GROUP SIGN IN SHEET

If you did not attend with a Group DO NOT SUBMIT THIS FORM.

Supervisor/Training Administrator: Please Complete this Form in its Entirety.

Please Submit within 24 Hours

*Questions with an Asterisk must be completed.

Any questions please contact the MSI Helpline 866-661-5120.
1.Select the MSI Live Course Title:(Required.)
2.Date and Start Time of the Course:(Required.)
Date / Time
Time
:
3.Agency (Employer):(Required.)
4.Department:(Required.)
5.Supervisor Information (Please complete all fields)(Required.)
6.If you have a Water/Wastewater License # please enter it below:
7.Did you attend the training?(Required.)
8.For Supervisor:
"I attest the submitted participants attended the entire course and were given the opportunity to ask questions about the material."(Required.)
9.Registered Name (Zoom):(Required.)
10.Did you attend the training?(Required.)
11.Number of Participants that attended the Training (Number Only): Please Complete the Participants Information on the "NEXT PAGE" by Clicking the the Green Button Below. Thank you (Required.)
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