ServSafe Request Form Home 5 ServSafe Request Form ServSafe Request Form FacebookThis field is for validation purposes and should be left unchanged.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.(Required) By Checking this box I confirm 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(Required) October 19, 2026 Comments or questionsPlease let us know if you have any questions or comments.
