OTI 5400 - Trainer Course in Occupational Safety & Health Standards for the Maritime Industry

OTI 5400 -Trainer Course in Occupational Safety & Health Standards for the Maritime Industry

Registration Form
(Items in Red are required fields)

First Name
Last Name
Degrees
Prof. Title
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E-mail
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Company
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Prerequisites:

Two years of occupational safety and health experience in the ship repairing, shipbuilding, shipbreaking, marine terminals, or longshoring industry.
And at least one of the following:

Two additional years of occupational safety and health experience in any industry;
A degree in occupational safety and health from an accredited college or university
Certification as an Associate Safety Professional (ASP), Certified Safety Professional (CSP), Certified Industrial Hygienist (CIH), Certified Marine Chemist (CMC), or Certified Safety and Health Manager (CSHM)

Please print this downloadable form and FAX to the OSHA Training Institute prior to the couse if you have doubts that prerequisites aren't meet. You will have to attest to the fact that you meet these prerequisites when you sign in on the first day of class. - Prerequisiste Verification Form

REFUNDS WILL NOT BE ISSUED IF PREREQUISISTES AREN'T MEET!

Coupon Code

Notes/Comments

Registration Dates, Locations and Fees

Please check which course you are registering for.

Course Registration: $750.00; $800 after January 1, 2010
Course hours are 8am - 4:30pm

	Location	Start Date	End Date
2010
	Tampa, FL	Monday, January 11, 2010	Thursday, January 14, 2010
	Gulfport, MS	Monday, March 01, 2010	Thursday, March 04, 2010
	Beaufort, NC	Monday, May 03, 2010	Thursday, May 06, 2010
	Orlando, FL	Monday, May 17, 2010	Thursday, May 20, 2010
	Savannah, GA	Monday, June 14, 2010	Thursday, June 17, 2010
	Miami, FL	Monday, July 12, 2010	Thursday, July 15, 2010
	Tampa, FL	Monday, July 26, 2010	Thursday, July 29, 2010
	Jacksonville, FL	Monday, August 30, 2010	Thursday, September 02, 2010
	Charleston, SC	Monday, October 18, 2010	Thursday, October 21, 2010
	Mobile, AL	Monday, December 06, 2010	Thursday, December 09, 2010

Payment Method
(Note: You will not be charged until registration is confirmed.)

Cancellation Policy
Cancellation notification must be in writing (FAX or email are acceptable). A cancellation fee equal to 25% will be assessed. Written cancellations received less than 5 working days prior to the event will be charged the cancellation fee plus the per-person cost. No-shows will be billed. Substitutes are welcome without penalty.

The Continuing Professional Education Office at the University of South Florida Health Sciences Center reserves the right to cancel this activity due to unforeseen circumstances. In the event of such cancellation, only the registration fee will be returned to the registrant.

Credit Card

	Mastercard
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	American Express

Name (exactly as on card)
Credit Card Number
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Check

Please make checks payable to:

USF HPCC
PO Box 864240
Orlando, FL 32886-4240

On your check, please include the program code which is printed on your confirmation and the registrants name or a copy of the registration.

Bill Later For Registrations Paid By PO

PO Number


If billing address is different than above - please list below
Company
Attn:
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Phone EMAIL

Security Notice

Accommodations for Disabilities: Please notify the CME Office, 12901 Bruce B. Downs Blvd., MDC Box 60, Tampa, Florida, 33612 or call (813) 974-6695 a minimum of ten working days in advance of the event if a reasonable accommodation for a disability is needed.

Events, activities and facilities of the University of South Florida are available without regard to race, color, sex, national origin, disability, age, or Vietnam veteran status as provided by law and in accordance with the University's respect for personal dignity.