OSHA 502 Nov 12-14, 2014, OSHA 500 Nov 18-21, 2014 NAME ______________________________________________ (Name Tag) TITLE _____________________________________________ FIRM _______________________________________________ ADDRESS __________________________________________ CITY/STATE/ZIP DAYTIME PHONE _____________________________________ ____________________________________ FAX # ______________________________________________ BILLING ADDRESS ___________________________________ EMAIL ADDRESS _____________________________________ SPECIALTY: qSafety Professional qIndustrial Hygienist qOther ________________________ ORGANIZATION: qGovernment qPrivate/Self qNGO qIndustry qAcademia qOther _____________ I HEARD ABOUT THIS COURSE FROM: qDirect Mail Brochure qRMCOEH Website qEmail Notification I have enclosed my tuition check for: qOSHA 510 - $650 qOSHA 502: $600 qOSHA 500: $675 which includes the course materials, and coffee breaks, and a $50 non-refundable cancellation fee if notice of cancellation received within 10 working days of course start date. q I have enclosed an additional $15 to cover DOPL fees and processing. Contractor License (required): ______________________ q Purchase Order # __________________________ ($7.50 processing fee will be charged)  I want to pay by credit card; I will call 801-581-4055 with the number. PLEASE make check payable, direct questions and mail to: RMCOEH Registration Coordinator University of Utah 391 Chipeta Way, Suite C Salt Lake City, Utah 84108 Telephone: (801) 581-4055 Fax: (801) 585-5275 Asbestos Inspector Refresher (Idaho Falls, Idaho) OSHA 502: Update for Construction Industry Outreach Trainers Asbestos Contractor/Supervisor Refresher (Pocatello, Idaho) Asbestos Inspector/Management Planner Refresher (Pocatello, Idaho) Sep 3 Sep 3-5 NON-PROFIT ORG. U.S. POSTAGE PAID Salt Lake City, Utah Permit No. 1529 OSHA 510 Nov 4-7, 2014 OTHER UPCOMING TRAINING COURSES Sep 4 Pulmonary Function (Spirometry) Testing Sep 8-9 CAOHC-Approved Occupational Hearing Conservation Sep 10-12 CAOHC-Approved Occupational Hearing Conservation Refresher Sep 11 OSHA 3095: Electrical Hazards OSHA 7505: Introduction to Accident Investigation (Williston, ND) OSHA 7300: Understanding OSHA's Permit-Required Confined Space Standard (Williston, ND) OSHA 510: Occupational Safety and Health Standards for the Construction Industry OSHA 502: Update for Construction Industry OutreachTrainers November 12-14, 2014 Salt Lake City, UT Sep 15-18 Sep 16 Sep 17 OSHA 510: Occupational Safety and Health Standards for the Construction Industry Sep 16-19 8-Hour HAZWOPER Refresher Sep 19 OSHA 5810: Hazards Recognition and Standards for On-Shore Oil and Gas Exploration and Production (Williston, ND) November 2014 OSHA Training Courses November 4-7, 2014 Salt Lake City, UT Sep 5 Sep 23-26 Visit our web site for more upcoming training from the RMCOEH http://medicine.utah.edu/rmcoeh/continuing-education/ course-calendar2014.php University of Utah Mountain West OSHA Training & Outreach Center Department of Family & Preventive Medicine 391 Chipeta Way, Suite C Salt Lake City, Utah 84108 REGISTRATION FORM OSHA 500: Trainer Course in Occupational Safety and Health Standards for the Construction Industry November 18-21 2014 Salt Lake City, UT Sponsored By: a consortium of OSHA Standards for the Construction Industry (OSHA #510) Trainer Course in OSHA Standards for the Construction Industry (OSHA #500) November 4-7, 2014 September 23-26 2014 This course for private sector personnel covers OSHA policies, procedures, and standards, as well as construction safety and health principles. Topics include scope and application of the OSHA construction standards. Special emphasis is placed on those areas that are the most hazardous, using OSHA standards as a guide. Prerequisites: None Cost: $650 Update for Construction Industry Outreach Trainers (OSHA #502) November 2-14, 2014 This course is designed for personnel in the private sector who have completed #500 Trainer Course in Occupational Safety and Health Standards for the Construction Industry and who are authorized trainers in the OSHA Outreach Training Program. It provides an update on such topics as OSHA construction standards, policies, and regulations. Prerequisites: Course #500 Authorized OSHA Outreach Trainers are required to attend this course once every four years to maintain their trainer status: Prior to registration, students must provide a copy of their current trainer card for validation. Cost: $600 This course is designed for personnel in the private sector interested in teaching the 10- and 30-hour construction safety and health outreach program to their employees and other interested groups. Special emphasis is placed on those topics that are required in the 10- and 30-hour programs as well as on those that are the most hazardous, using OSHA standards as a guide. Course participants are briefed on effective instructional approaches and the effective use of visual aids and handouts. This course allows the student to become a trainer in the Outreach Program and to conduct both a 10- and 30-hour construction safety and health course and to issue cards to participants verifying course completion. Note: Students in Course #500 who wish to participate as authorized trainers in the OSHA Outreach Training Program must prepare a one-hour presentation on an assigned OSHA Construction Industry topic individually or as part of a group and successfully pass a written exam at the end of the course. Please bring a flash drive or laptop, if possible, for your presentation. Prerequisites: Course #510 and five (5) years of construction safety experience. A college degree in occupational safety and health, a Certified Safety Professional (CSP) or a Certified Industrial Hygienist (CIH) designation, in the applicable training area may be substituted for two (2) years of experience. To determine if you meet these eligibility requirements, please visit http://medicine.utah.edu/rmcoeh/ContEdProg/MtnWestOSHA/index.htm. Look for Outreach Trainer Information and download the prerequisite protocol document. Cost: $675 GENERAL INFORMATION REGISTRATION The Mountain West OSHA Training and Outreach Center is offering the OSHA 502 for $600, the OSHA 510 for $650 and the OSHA 500 for $675. Tuition includes course materials (including a copy of the pertinent regulations), coffee breaks, and course credits. Payment IN FULL must be received prior to the start of the course. 4 Easy Ways to Register TELEPHONE (801-581-4055) your registration, followed by payment or purchase order within two weeks. ONLINE registration (https://umarket.utah.edu/ um2/rmcoeh) is available; payment must follow within two weeks. FAX (801-585-5275) your completed registration form, followed by payment or purchase order within two weeks. MAIL completed registration form with check or company purchase order to the address on the registration form. You are considered registered when full payment or a purchase order has been received. If you expect payment delays, send completed registration form now and your payment within two weeks. Disability accommodations require advance notice at time of registration or you may contact the Program Coordinator at (801) 581-4055 prior to the course. Registrations should not be considered confirmed until a written confirmation letter is received by the course participant. Confirmation letters are mailed within 5 working days of receipt of registration form. If you have further questions or need assistance, please contact Registration Coordinator, RMCOEH, 391 Chipeta Way, Suite C, University of Utah, Salt Lake City, Utah 84108, (801) 581-4055 (Fax: 801-585-5275). CANCELLATION/SUBSTITUTION POLICY If you are unable to attend, a substitution can be made at any time without charge. Refunds, less a $50 administrative fee, can be issued on request for all cancellations except those postmarked or faxed within 10 business days of the course, for which no refunds or credit will be given. The University reserves the right to cancel programs if necessary. In this event, the University's liability is limited to the full refund of your registration fee. CREDITS All courses will be awarded Continuing Education Units (CEUs), the national standard for recognition of non-university professional education. Courses are eligible for ABIH CM points. The OSHA 510, 502 and 500 courses have been approved for 6 core credit hours for contractors and 4 hours for electricians and plumbers by the State of Utah’s Division of Occupational and Professional Licensing for those who hold a license in Utah. The fee for this credit is an additional $15