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

COURSE REGISTRATION FORM
For questions regarding course registration or to register
over the phone, please call (800) 326-7568


Please review our cancellation policy prior to submitting your registration. This registration form is for our live-classroom courses. To register for our online courses, please log-on to our online training site www.regionxoti.org

* indicates a required field.

* Course:

Course Number + Course Title

Location

Date
Example:
OSHA 2015 Hazardous Materials
Seattle
2/4-7/08

*ID:

Please enter the first 4 letters of your last name
Please enter the month and day of your birthdate (i.e. mmdd)
*Full Name:
Degree(s):
Job Title:
Check this box if part of a group registration. Then, enter group name:

Organization:
*Address:
*City:
* State: * Zip:
*Phone:
* Fax:
*E-mail:
Comments:
OCCUPATION EMPLOYER
Attorney Federal Government
Educator State/Provincial Government
Environ. Health Professional Local Government
Engineer Consulting Services
Epidemiologist Educational Services
Health Physicist Insurance
HR/Risk Manager Legal Services
Industrial Hygienist Manufacturing
Nurse Medical Services
Physician Union
Public Health Other:
Safety Professional
Toxicologist
Training Coordinator
Worker Representative
Other:  
 
Please let us know how
you heard about this class:

If other:

Please note: Your registration will not be complete until we have a valid credit card on file or until a check has been received.

VISA/MC

To complete registration please call with your credit card number.

For NW Center Courses please call (206) 543-1069
For OSHA Courses please call (206) 685-3089

Check

Please make check payable to University of Washington. Payment should arrive before the start date of the course.

Payment Address:
Pacific NW OSHA Education Center
University of Washington
4225 Roosevelt Way NE, Suite 100
Seattle, WA 98105

Please note the DEH Continuing Education Program cannot take credit card numbers on-line at this time. We are working to get a secure server in order to serve you better.

Yes! I am interested in subscribing to the ENVHLTHCE Listserv!

Yes! I am interested in receiving course brochures and catalogs!
By clicking submit, you indicate that you have read the DEH CE cancellation policy.

For more information on the DEH 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
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*Your check payment will be processed by Student Fiscal Services (SFS) at the University of Washington. SFS processes checks electronically using the information on the check to create an electronic funds transfer. Each time you send a check, you authorize a one-time transfer where funds will be electronically withdrawn from your bank account. You will not receive your canceled check as SFS is required to destroy the check after it has been processed. For more information or to stop the conversion of your check, please contact SFS at (206) 543-4694 or email at sfshelp@u.washington.edu.