COURSE REGISTRATION FORM

Please register the following person(s) for classes checked below:

* June 13 - Adult CPR Certification Training
* June 13 - First Aid Certification Training
* June 17 - Forklift Operator Classroom Safety Training
* July 18 - Adult CPR Certification Training
* July 18 - First Aid Certification Training
* July 2 - OSHA Trenching, Excavation & Soil Mechanics
* July 2 - OSHA Confined Space Entry Training
* July 15 - How to Administer a Respirator Program
* July 15 - Creating Safety Toolbox Training
* July 24 - Fall Protection Training for the Competent Person
* July 24 - Handling & Storage of Hazardous Gases & Liquids
* Aug. 8 - Adult CPR Certification Training
* Aug. 8 - First Aid Certification Training
* Aug. 11 & 12 - 10 Hour OSHA General Industry Standards Training
* Aug. 21 - OSHA Electrical Safe Work Practices & NFPA 70E Arc Flash/Blast
* Sept. 10 - Forklift Safety Instructor Development Course
* Sept. 11 - Incident Investigation Training & Introduction to Root Cause
* Sept. 11 - OSHA Record Keeping and Injury Classification Training
* Sept. 15-18 - OSHA 502 Update for Construction Industry Outreach Trainers
* Sept. 23 - Hazard Communication Do's and Don'ts
* Sept. 23 - Silica "It's Not Just Dust"

Name(s)                                                                                                                                                                    

                                                                                                                                                                                

                                                                                                                                                                                

                                                                                                                                                                                

                                                                                                                                                                                

Company                                                                                                                                                                  

Address                                                                                                                                                                    

                                                                                                                                                                                

Phone#                                     Fax #                                     email:                                                                         

* Check enclosed for person(s): $                          * Purchase Order #                                            

* Visa or MasterCard No.                                                                                                  Exp. Date:                         



Signature:                                                                                    

Please print out form & Mail to:

Delaware Safety Council, Inc., 3 Old Barley Mill Road, Wilmington DE 19807
or FAX to 1-302-654-4617

Cancellation Policy: Cancellations must be received at least 48 hrs. prior to seminar.  There is a 50% charge on late cancellations.  No refunds or crdeits can be made on non-canceled registrations.  Delaware Safety Council reserves the right to cancel classes in the event of unforeseen circumstances or a lack of enrollments.