2. Registration Info/Form - University of Georgia Marine Extension

University of Georgia Marine Extension & GA Sea Grant
Segment 2 Seafood HACCP Course
Atlanta Farmers Market
16 Forest Parkway, Forest Park, GA 30297
May 12, 2015
The University of Georgia Marine Extension and Georgia Sea Grant are offering a Segment Two
Hazard Analysis Critical Control Point (HACCP) training course for seafood processors, packers,
wholesalers, and importers. Under U.S. Food & Drug Administration (FDA) and Georgia regulations,
seafood companies are required to have at least one employee with seafood HACCP training or
experience to develop and implement HACCP plans specific for their product(s) and facility.
ALL PARTICIPANTS:
• Must complete the online Segment 1 course at http://seafoodhaccp.cornell.edu/Intro/02.html
before registering for this Segment 2 course (documentation required)
• Will receive a certificate recognized by the FDA and the Georgia Department of Agriculture
that documents they have been trained in seafood HACCP
WHEN:
8:30 AM to 5:00 PM, Tuesday, May 12, 2015
WHERE:
Visitor Center, Atlanta Farmers Market; 16 Forest Parkway, Forest Park, GA 30297
COST:
• $154.00 per person, payable by check or money order made out to
“UGA Marine Extension Service.” We cannot accept credit card payments.
• Includes copy of FDA’s Fish & Fisheries Products Hazards & Controls Guidance, 4th edition April 2011. (If you prefer Spanish version, please note on registration form.)
• Payment MUST accompany completed registration form (next page) and be received by
Friday, May 1 to reserve your place.
Additional Information:
• Class size limited to 15 people.
• You will receive emailed message confirming successful registration.
• Course is taught in English; participants are expected to remain entire time & fully participate.
• No lunch provided; attendees may bring food with them or purchase it from nearby restaurants.
For more information about this course, visit http://marex.uga.edu/haccp_training or contact
Tori Stivers, AFDO/Seafood HACCP Alliance Qualified Trainer
University of Georgia Marine Extension & Georgia Sea Grant
770/460-2506; tstivers@uga.edu
The University of Georgia:
A Land and Sea Grant Institution
University of Georgia Marine Extension Service
Segment 2 Seafood HACCP Course Registration Form
Registration Checklist:
Register me for the May 12, 2015 Segment 2 HACCP course in Forest Park, GA.
Online Segment 1 course completion notice included (required to register).
Check or money order for $154.00 payable to UGA Marine Extension Service
enclosed* (no credit card payments accepted)
Please type or print clearly. If your writing is illegible, we cannot process your
registration! You will receive an email confirming successful registration.
FIRST NAME ___________________________________MIDDLE INITIAL ____________
LAST NAME ______________________________________________________________
COMPANY/AGENCY _________________________________ Number of Employees ____
MAILING ADDRESS (this is where your HACCP certificate will be sent)
___________________________________________________________________________
CITY _________________________________ STATE___________ ZIP_________________
PHONE(S)__________________________________________________________________
FAX ______________________________________________________________________
E-MAIL ____________________________________________________________________
SEAFOOD PRODUCTS SOLD __________________________________________________
YOUR PROFESSIONAL AFFILIATION: Please select only one category listed below:
Industry
Regulator
Educator
Consultant
Other
Mail completed form along with payment and documentation of Segment 1 completion to:
Tori Stivers
UGA Marine Extension Service
P.O. Box 2156
Peachtree City, GA 30269
* Due to high demand for this course, you must notify Tori Stivers (770/460-2506;
tstivers@uga.edu) by 8:00 AM Friday, May 1, 2015 if you are unable to attend and wish to
receive a refund.