Ecolab Sanitation/Food Safety Workshop Registration Form Please be sure to offer complete and valid information, as it will be used

to generate your name badge, certificate of attendance, confirmation letters, billing for workshop fees and hotel registration. This form must be filled out completely to be considered registered for the class. That includes the account number & billing

portion of this form. Last Name Traboulay Please select a workshop. First Name Peter Title Vice-President, Technical Services Company S. M. Jaleel and Co. Ltd Street Otaheite Industial Estate, South Oropouche City/State/Zip Trinidad & Tobago Phone Number and Extension 1-868-677-7520 ext. 2715 Fax Number 1-868-677-7825 E-Mail Address peter.traboulay@chubbysd.com

Ecolab Account Manager Neil Rawlins (Ecolab Barbados)

January 25 29, 2010 (Registration deadline is December 25, 2009)

April 12 16, 2010 (Registration deadline is March 12, 2010) June 14 18, 2010 (Registration deadline is May 12, 2010) August 9

13, 2010 (Registration deadline is July 9, 2010) October 18 22, 2010 (Registration deadline is September 18, 2010) November 15 19, 2010 (Registration deadline is October 15, 2010) Ecolab Account Number 0001782 Check if you would NOT like your name to be included

in a participant list given to workshop attendees. Registration (includes daily lunch, refreshment breaks and tour) Ecolab Customers Full Workshop 5 days $1295.00 1 Additional Employee same company $1050.00 1 *** (Note: Discounted rate only applies to customers paying by credit card PO or check) *** Non-Ecolab Customers (Note: 5 day workshop attendance is recommended) Full

Workshop 5 days $2095.00 Payment-Selectmethodofpaymentfortheregistrationfee:MUSTBECOMPLETED! Checkenclosed(checkmustbemailed,notfaxed,andshouldbepayabletoEcolab,Inc.) P.O.invoicewithmycompany:P.O.Number(P.O.requiredforinvoicing) CreditCard(forsecurity,pleasecalldirectlywiththisinformationafterfaxingregistrati on) Contract/FundContractnumberHotel(Pleasecheckone) IwouldlikeEcolabtobookmearoommeatEmbassySuites (Please wait until final confirmation letter is received 3 weeks prior to class to make any pre-payment arrangements with the Embassy Suites) Hotel Arrival Date: 24 January 2010 Hotel Departure Date 30 January 2010 Smoking Preference: Non-Smoking Smoking I do not need

a hotel/will make arrangements myself or through my corporate travel agent