School of public health and community medicine Department of environmental health University of Washington
CONTINUING EDUCATION NORTHWEST CENTER REGION X OSHA FAQ CONTACT US SEARCH
MISSION ONLINE TRAINING ONSITE TRAINING CERTIFICATE SURVEY LISTSERV LINKS

 

 Safety & Health Certificate Application Form

For questions regarding certificate application, please call (206) 685-3089


Student ID:
  First 4 letters of your last name
(use X to fill leftover blanks) 		Month and day of your birthdate: MMDD

Please select the certificate for which you are applying:
If you wish to apply for more than one certificate, you must fill out a separate application for each certificate.

Safety & Health Construction Specialist (Requires 5 years of safety experience)
Safety & Health General Industry Specialist (Requires 5 years of safety experience)
Disaster Site Worker Specialist (Requires 5 years of safety experience)
Safety & Health Leadership Specialist

Name:
Title:
Organization:
Address:
City:
State:
Zip:
Phone:
Fax:
E-mail:
   

List below
What certifications, degrees, or work-related training do you have?

You must list five years of cumulative safety experience for the Construction, General Industry, & Disaster Site Worker Certificates.
      
Yes! I am interested in subscribing to the ENVHLTHCE Listserv!
 
 

For more information on the DEOHS CE program, please contact our office.
Northwest Center : (206) 543-1069
OSHA Training Institute : (206) 685-3089 or (800) 326-7568
Fax: (206) 685-3872
Email:ce@u.washington.edu
This page was lasted edited on .