O S H A 1 0 -H o u r C e r ti fi c a ti o n C o u r s e · 2021. 1. 6. · January 26t h & 28t h....

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Payment Information Total Amount: $___________ Contact Name: _____________________________ Company: ______________________________ Phone Number: (___)____-_____ Email Address: ________________________________________ Name on Card: ____________________________ Card #: _________________________________ Exp: _____/________ Security Code: _________ Billing Address: ___________________________ City: ___________ State: _____ Zip Code: _______ Signature: _______________________________ Attendee 3: _____________________________ Attendee 3 Email: ________________________ Attendee 3 Cell Phone: ____________________ Attendee 4: _____________________________ Attendee 4 Email: ________________________ Attendee 4 Cell Phone: ____________________ Attendee Information (please use direct contact emails and phone numbers) Attendee 1: _____________________________ Attendee 1 Email: ________________________ Attendee 1 Cell Phone: ____________________ Attendee 2: _____________________________ Attendee 2 Email: ________________________ Attendee 2 Cell Phone: ____________________ January 26th & 28th January Course February 16th & 18th February Course Please select which course you'd like to attend by checking the corresponding box. This industry certification course provides basic hazard awareness, recognition, avoidance, and correction for all employees working on a construction site. The course provides information on the OSHA/MIOSHA agencies, construction standards, the Focus Four categories of accidents (falls, electrical, struck-by and caught-in-between), construction PPE, ladder safety, hands-on activities and lots of Q&A time. Only nine seats are available and all nine seats must be filled to run the class. This class will be cancelled if the seat count is not met. Payment will not be processed until capacity is met. 15 minute break will take place at 10:00 AM. A half hour long lunch break will take place from 11:30 AM - 12:00 PM. We are requesting attendee cell phone numbers for direct contact in the event of class cancellation due to weather or other unforeseen events. This class is exclusive to Builders Exchange of Michigan members only. OSHA 10-Hour Certification Course Time: 8:00 AM - 2:00 PM Location: RVC Conference Room 678 Front Ave NW Ste 212 Grand Rapids, MI 49504 Price: $199 per attendee Includes student card! Return completed registration form & payment to: Katie Hawley Fax: 616.949.6831 Email: [email protected] Mail: PO Box 2031 Grand Rapids, MI 49501 Want to pay by Credit Card over the phone? Call Katie at 616.949.8650 Registration & payment must be received by January 22, 2021 for January Course or February 12, 2021 for February Course. No cancellations will be accepted after January 22, 2021 for January Course or after February 12, 2021 for February Course. Questions? Contact [email protected]

Transcript of O S H A 1 0 -H o u r C e r ti fi c a ti o n C o u r s e · 2021. 1. 6. · January 26t h & 28t h....

Page 1: O S H A 1 0 -H o u r C e r ti fi c a ti o n C o u r s e · 2021. 1. 6. · January 26t h & 28t h. Jan u ary Co u rse. F e b ru a ry 1 6 t h & 1 8 t h. F e b r u a r y C o u r s e.

Payment InformationTotal Amount: $___________

Contact Name: _____________________________ Company: ______________________________

Phone Number: (___)____-_____ Email Address: ________________________________________

Name on Card: ____________________________ Card #: _________________________________

Exp: _____/________ Security Code: _________ Billing Address: ___________________________

City: ___________ State: _____ Zip Code: _______ Signature: _______________________________

Attendee 3: _____________________________

Attendee 3 Email: ________________________

Attendee 3 Cell Phone: ____________________

Attendee 4: _____________________________

Attendee 4 Email: ________________________

Attendee 4 Cell Phone: ____________________

Attendee Information (please use direct contact emails and phone numbers)Attendee 1: _____________________________

Attendee 1 Email: ________________________

Attendee 1 Cell Phone: ____________________

Attendee 2: _____________________________

Attendee 2 Email: ________________________

Attendee 2 Cell Phone: ____________________

January 26th & 28thJanuary Course

February 16th & 18thFebruary Course

Please select which course you'd like to attend by checking thecorresponding box.

This industry certification course provides basic hazard awareness,recognition, avoidance, and correction for all employees working on aconstruction site.

The course provides information on the OSHA/MIOSHA agencies,construction standards, the Focus Four categories of accidents (falls,electrical, struck-by and caught-in-between), construction PPE, laddersafety, hands-on activities and lots of Q&A time.

Only nine seats are available and all nine seats must be filled to runthe class. This class will be cancelled if the seat count is not met.Payment will not be processed until capacity is met.

15 minute break will take place at 10:00 AM. A half hour long lunch break will take placefrom 11:30 AM - 12:00 PM. We are requesting attendee cell phone numbers for directcontact in the event of class cancellation due to weather or other unforeseen events.This class is exclusive to Builders Exchange of Michigan members only.

OSHA 10-Hour Certification Course

Time:8:00 AM - 2:00 PM

Location:RVC Conference Room678 Front Ave NW Ste 212Grand Rapids, MI 49504

Price:$199 per attendeeIncludes student card!

Return completedregistration form & payment to: Katie HawleyFax: 616.949.6831Email: [email protected]: PO Box 2031Grand Rapids, MI 49501

Want to pay by Credit Card over the phone? Call Katie at 616.949.8650

Registration & payment mustbe received by January 22,2021 for January Course orFebruary 12, 2021 for FebruaryCourse. No cancellations willbe accepted after January 22,2021 for January Course orafter February 12, 2021 forFebruary Course.

Questions? [email protected]

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