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North Central District Health Department Enfield - 31 North Main Street Enfield CT 06083 - 860 745-0383 FAX 745-3188 Vernon - 375 Hartford Turnpike Room 120 Vernon CT 06066 - 860 872-1501 FAX 872-1531 Windham - Town Hall 979 Main Street Willimantic CT 06226 - 860 465-3033 FAX 465-3032 Stafford -Town Hall 1 Main Street Stafford Springs CT 06076 - 860 684-5609 FAX 860 684-1768 SERV-SAFE COURSE REGISTRATION FORM Date Establishment Name City State Zip APPLICANT INFORMATION Last Name First...

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