Empire Safety Council

176 Terry Rd. Smithtown NY 11787

Phone: 1-800-246-3603 Fax: 631-360-2160

Class Schedules at Training Centers

ATT: All Delivery Agents / Instructors

Please list dates and locations of Personal Watercraft/Boating Safety Class offerings in the next four (4) month period. (you may send a yearly schedule). Classes must be registered with OPRPH two weeks prior to being taught. We will forward your schedule to Parks Dept. and list on their website for you. You can fax or mail your schedule to ESC. Please include referral phone number.

Today’s Date:___________________

Official Course Provider: Empire Safety Council

Official Material Provider: Empire Safety Council

Instructor Name___________________Parks Boating Safety Instructor #____________

Referal Phone Number_________________________

Course Address and location Date Time #of sessions Your Code

_______________________________________________________________________

County:__________________ Maximum Class Size:____________________________

Adults and/or Children?________ What is the fee?_________ Post on Website?_______

Contact Phone Number for Website__________________________________________