Food Handler Certification Registration

Food Handler Certification Registration

Please complete the information on this page to register your food handler or food manager certificate with the city.

PERSONAL INFORMATION

FIRST NAME*

LAST NAME*

STREET ADDRESS*

CITY*

STATE*

Select or enter value

ZIP*

PHONE NUMBER*

EMAIL ADDRESS*

SEX*

Select

AGE*

EMPLOYER INFORMATION

RESTAURANT/PLACE OF EMPLOYMENT*

Select or enter value

CERTIFICATE INFORMATION

NAME OF FOOD HANDLER CERTIFICATE COMPANY*

Select or enter value

TYPE OF CERTIFICATION*

Select or enter value

CERTIFICATE NUMBER

DATE FOOD HANDLER COURSE TAKEN*

DATE FOOD HANDLER COURSE EXPIRES*

Please check the box the box below to have a copy sent to you.

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