The personal information on this form is collected under the authority of the Health Protection and Promotion Act and will be used for the administration of Public Health programs. Any questions about the collection of this information should be directed to the Manager of Environmental Health, Renfrew County and District Health Unit at 141 Lake Street, Pembroke, Ontario K8A 5L8, 613-732-3629 ext. 505, Fax: 613-735-3067Course Date* Date Format: DD dash MM dash YYYY Name* First Last Address* Street Address Address Line 2 City Province AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Postal Code Phone*Email Note: If you have an expired certificate from a provincially-recognized food handler training course, you have the option of writing the exam without having to take the course over again. Please call 613-732-3629 extension 505 for more details. If you want to fax (613-735-3067) the completed registration form in addition to submitting it online, make sure you print the form before pressing the ‘submit’ button. Please call us at 613-732-3629 ext. 505 or 1-800-267-1097 to confirm your registration once you have submitted the form online. Please be aware that you require a course manual. Call us for further details.