Training Order Form

What Return on Investment Can Safety & Health Provide?

Improved Employee Morale

Decreased Lost Time

Fewer Workplace Injuries

Lower Insurance Costs

Safety Culture Adoption

Compliance with OSHA Regulations offering protection from expensive fines.

Training Order Form

Use this form to register for classes or to request that the response team contact you to schedule private training.

You may also contact our offices directly at

479-876-1000 to register.

Name: Company:

Address:

City: State: ZIP:

Phone: Fax:

Email:

Payment: A Safe Sites representative will contact your to confirm your registration and to make arrangements for payment.

Which class(es) would you like to register for?

10-HOUR OSHA OUTREACH    January 13 and 20 2007
30-HOUR OSHA OUTREACH    March 7, 14 and 21, 2007
FORKLIFT OPERATOR CERTIFICATION     November 3, 2006

FORKLIFT OPERATOR CERTIFICATION December 1, 2006

FALL PROTECTION CERTIFICATION   November 15, 2006
SCISSOR LIFT CERTIFICATION
BOOM LIFT CERTIFICATION
COMB. BOOM/SCISSOR LIFT CERTIFICATION      December 7, 2006

I would like Safe Sites to contact me regarding a private class.

Comments:

This form may also be printed and submitted by facsimile.

To download, right click and "save as".

Safety Program Order Form

You may submit this form via e-mail or Fax to 479.876.1000. A consultant will promptly contact you for a brief interview prior to preparing your program material. Payment arrangements will be made at that time.