Date
Name:
Payroll
Number
Home address:
Providing an e-mail address
allows us to e-mail you ICD
updates.
E-mail address:
Phone number:
Course name:
Start Date:
End Date:
Cost:
Address
City
In addition to this application you must submit all
supporting documentation
by mail
or in person to Jessica Carpio, USS-POSCO Industries, 900 Loveridge Road, P.O.
Box 471, Pittsburg, CA 94565
If you cannot attend the first class you must notify ICD prior to the first class. You
can do this by calling Jessica Carpio at 439-6189 or e-mailing her at
jcarpio@ussposco.com. Failure to notify may cause you to forfeit your allocated
funds for the class or your registration in the class.
I authorize the course vendor(s) of the course(s) listed above to release any
information requested by UPI Career Development regarding tuition paid,
attendance, and completion of courses.
Retiree
Customized Course Registration
ICD
