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Food Safety Certification
Reimbursement Application
To apply, select one of the following:
- Apply
on-line.
- View or print the application
(3 pages) from PDF format.
You will need Adobe® Reader 5.0
or higher to view or print this document.
Mail or fax completed application and attachments to:
- Karen Peckham
- IDDBA
- P.O. Box 5528
- Madison, WI 53705-0528
- phone 608.310.5000 fax 608.238.6330
Don't forget to mail or fax these REQUIRED
elements:
- Copy of invoice for payment of training, workshop, and exam
for each employee.
- Copy of certification certificate awarded to each employee or
pass list on testing company letterhead.
- Name, store address, and home address for each certified employee.
You must include the specific store name and title for each employee.
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