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Worker Handler Refresher Class                                        February 10, 2026
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Email *
First Name *
Last Name *
Address *
Phone number (Cell) *
NYS Driver's License Number (Write entire number) *
Employer   *
Employer   Address
Employer   Phone Number
Email Address, Contact Person *
Employer Contact Person
Date of last initial or refresher course *
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Where did you take your last initial or refresher course? *
Training Class - Price *
Do you want Alpine to send your certification paperwork to NYS Department of Labor? 
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Payment Options *
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