ServSafe Request Form Home 5 ServSafe Request Form ServSafe Request Form Name(Required) First Last Email(Required) Phone Number(Required)Company(Required)My affiliation with Y. Hata(Required) I am a current customer of Y. Hata. I am an account manager at Y. Hata. I am not affiliated with Y. Hata. Account Manager at Y. Hata(Required)Please type NA if you do not have an account managerDo you have a laptop?(Required) Yes I have a laptop and I will bring it with me to the class. No, I will need to borrow a lap top. $175 ServSafe Manager Course Payment must be submitted by check or card only. By Checking this box I conform that I understand the cost of the ServSafe class is $175 check or card and that no cash will be accepted.ServSafe Date of Interest June 16, 2025 July 21, 2025 August 18, 2025 September 15, 2025 October 20, 2025 Comments or questionsPlease let us know if you have any questions or comments.
