How to Register for APTI Courses
Please fill out a Registration Form for each class you would like to attend and send the application(s) along with payment (check, credit card number or purchase order number as appropriate), if there is a cost for the course, to Ron Lauck by fax, email , or mail (see contact information).
Please be sure to fill out the Registration Form including the requested information on your education and background to assist the instructor(s) in tailoring the course to better meet the needs of the students attending the course.
In addition to registering with the Rutgers Air Pollution Training Program, please also register at the USEPA Air Pollution Training Institute (APTI) at: http://www.apti-learn.net/LMS/EPAHomePage.aspx
. This will ensure that you receive a certificate from Rutgers University as well as the USEPA-APTI. Once you are on the APTI website, click on the “register” button. If you have not previously registered on this site you will need to create a username and password (follow the instructions found on that page). Once you have logged on with your username and password you can register for the course. Please contact us if you need assistance registering for the course.

Applicant Information:
Name:
Agency Title:
Street address or P.O. Box number :
City:
State: Zip Code:
Work Telephone:
Work Fax:
Email:
Country:
Payment Information and Method:
The course fees are listed on the Rutgers Air Pollution Training Program website.
Course Fee: $ Please be sure to select the appropriate fee based on your employment status.
A confirmation letter will be sent to you via email (preferred method, if available), fax, or postal mail following receipt of the registration form. Please contact Ron Lauck at 848-932-5788 for payment questions or to arrange for payment by credit card.
Check Credit Card Bill later
Billing Contact (if selected “Bill later” above):
Telephone #:
Email:
Course Information:
Course number and Name:
Dates of Course:
2
Rutgers Air Pollution Training Program
Questionnaire for Training

Other Comments or Questions from Applicant :
Applicant Information:
Name:
Organization Information:
USEPA State Agency
Tribal Organization Private Sector
University Other:
Local Agency
Department of Defense
Job Title and Description:
Title:
Total years experience in present job:
Total years experience in air pollution:
What responsibilities does your job involve (please check all that apply)?
Source
Sampling/Monitoring
Ambient Monitoring Atmospheric Sampling
Monitoring Site Operation Emissions Inventory Equipment Calibration
Enforcement/Compliance Permit Writing Modeling
Other (please briefly describe):
Previous Air Pollution Training Courses Attended:
Course Title Course
Number
Dates attended
3
Rutgers Air Pollution Training Program
Questionnaire for Training

Education:
High School graduate? Yes
Name of College or University
No
Dates attended Major
Other Comments or Questions from Applicant: Feel free to include items of interest related to course subject matter that you would like to see the instructors discuss:
Degree
4
Rutgers Air Pollution Training Program
Questionnaire for Training