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OUTREACH TRAINING
PROGRAM
GUIDELINES
MARITIME INDUSTRY
SAFETY AND HEALTH
U.S. Department of Labor
Occupational Safety and Health Administration (OSHA)
Directorate of Training and Education
2020 S. Arlington Heights Road
Arlington Heights, Illinois 60005 |
November 2007
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TABLE OF CONTENTS |
Background
The Maritime Industry Outreach Training Program
Outreach Training Program Guidelines
Outreach Training Tips
Designated Training Topics: 10-hour Maritime Industry Training Outreach Program
Designated Training Topics: 30-hour Maritime Industry Training Outreach Program
Further Assistance
Program Administration
Obtaining Student Course Completion Cards
Information on Student Course Completion Cards
Replacing Lost
or Damaged Trainer or Student Cards
OSHA Outreach Training Program Report
Attachment A - OSHA Training Institute Education Centers (OTIECs)
Attachment B - OSHA Outreach Training Program Fact Sheet
Attachment C - Shortcut Procedures for Outreach Trainers with ID Numbers
MARITIME INDUSTRY
OUTREACH TRAINING PROGRAM |
BACKGROUND
The Occupational Safety and Health Administration's (OSHA) Outreach Training Program is a voluntary
train-the-trainer training program through which OSHA authorizes trainers to teach construction and
general industry occupational safety and health standards and policy. We have promoted workplace
safety and health by authorizing trainers since 1971.
The Maritime Industry Outreach Training Program began in September 2007.
The outreach program has grown rapidly in recent years. In the past five years, 1.9 million workers
have received outreach training; the program has doubled in growth. In 2007, we distributed over
520,000 student cards to trainers who held over 35,000 classes – an average of over 680 classes per
week. The number of students completing the 30-hour construction training has almost quadrupled in
the past 4 years; however, 10-hour classes still comprise 85% of the overall program. And 80% of all
the outreach training is in construction On any day, approximately 2,200 workers attend OSHA
outreach training.
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Text Version of Chart: OSHA Outreach
Training Program
Type: Vertical Bar Graph
Graph Elements: 32 - Two bars for each year from 1992 to 2007 representing the number of students
trained for Construction and General Industry
Construction: Students trained from 1992 to 2007
- 1992 - 20,903
- 1993 - 33,133
- 1994 - 40,690
- 1995 - 63,742
- 1996 - 66,818
- 1997 - 74,537
- 1998 - 107,760
- 1999 - 129,909
- 2000 - 149,026
- 2001 - 169,560
- 2002 - 203,776
- 2003 - 217,691
- 2004 - 242,421
- 2005 - 296,096
- 2006 - 349,309
- 2007 - 413,576
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General Industry: Students trained from 1992 to 2007
- 1992 - 3,060
- 1993 - 7,426
- 1994 - 10,390
- 1995 - 20,489
- 1996 - 26,687
- 1997 - 30,850
- 1998 - 43,448
- 1999 - 45,937
- 2000 - 51,496
- 2001 - 55,272
- 2002 - 50,627
- 2003 - 63,094
- 2004 - 62,941
- 2005 - 79,931
- 2006 - 91,796
- 2007 - 106,164
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This growth is as a result of wide industry acceptance. Many organizations use
the Outreach Training Program to provide training for their members. Groups which have implemented
formalized use of the program include the building trades, general contractors, employer
associations, insurance companies, and manufacturing firms. The endorsement of this training, to
serve as a foundation of occupational safety and health training, has often resulted in the
requirement of the training as a condition of employment for their workers or members.
Recent State laws enacted in Massachusetts, Rhode Island, Connecticut, New Hampshire, and New York
require 10-hour construction training for workers on various sized publicly funded projects.
THE MARITIME INDUSTRY OUTREACH TRAINING PROGRAM
Maritime industry outreach trainers are authorized to conduct 10- and 30-hour Maritime industry
outreach courses and receive OSHA course completion cards to issue to their students. To become an
authorized trainer, you must complete Course #5400, OSHA Trainer Course for
the Maritime Industry. You must pass a final test to receive your trainer authorization.
Update Requirement. To stay current on OSHA, Maritime Industry outreach
trainers must attend Course #5402, Update for Maritime Industry Outreach
Trainers, every four years to remain authorized. The OSHA course #5400 may also be used
to maintain a trainer’s authorized status.
If your trainer authorization status has expired, you have a three month grace period after your
expiration to take the update course. After the three month period, you may only reinstate it by
retaking the OSHA #5400 course.
OSHA Training Institute Education Centers (OTIECs) conduct the trainer courses (see
Attachment A).
Student Courses. The 10- and 30-hour student courses are numbered and
named as follows:
10-Hour
- Course #7615, Shipyard Employment, including ship repairing, shipbuilding, shipbreaking
- Course #7617, Marine Terminals
- Course #7618, Longshoring
30-Hour
- Course #7635, Shipyard Employment, including ship repairing, shipbuilding, shipbreaking
- Course #7637, Marine Terminals
- Course #7638, Longshoring
OUTREACH TRAINING PROGRAM GUIDELINES
Training Topics. See the Designated Training Topics section for what you must cover in the 10- and
30-hour Maritime industry classes. Because the objectives of the training are different, you may
supplement, but not combine, the outreach program topics with training required in the OSHA
standards. CPR and First Aid may only be supplementary topics.
Topic Length. We recommend you cover each course topic for an hour. At times, however, your audience
may have limited exposure to a hazard and one-half hour is appropriate. One-half hour is the minimum
you may spend on a topic. In the 10-hour class, don’t cover any topic for more than four hours. In
the 30-hour class, don’t cover any topic for more than six hours.
Training Materials. Trainers compile materials for their training from a variety of sources,
including products OSHA has available under “Teaching Aids” at the OSHA
Outreach Training Program web site. The course materials provided in the trainer classes are not
designed for outreach students. Provide your students with materials (at least a fact sheet) on each
topic you cover, containing key points. See the Further Assistance section for additional
information.
Class Time. Breaks and lunch periods are not counted as class time.
Classes Over a Period of Time. You may break classes into segments. Each
segment must be at least one hour and the course must be completed within six months.
Guest Trainers. You may use trainers who have topic expertise to help
you conduct classes. The authorized outreach trainer must design and coordinate the course, teach
more of the class than anyone else, and attend all sessions to answer questions and ensure topics
are adequately covered and all students are in attendance.
Class Size. If your class will exceed 50 students, contact your Outreach
Coordinator (Attachment B) prior to the class to receive permission to hold the class and receive
student cards. Inform the coordinator how you will address these items:
- How students will be able to ask questions when the class is not in session. Methods include
e-mail, answering questions after class, and a Q & A session.
- What materials, in general, you are providing to the students. You must provide your students
with at least a fact sheet on each topic you cover.
- That attendance will be taken at least at the beginning and end of the class. Only those people
who are on all the attendance sheets may receive cards.
We recommend using more than one trainer, holding the 10-hour over more than one day, and breaking
the class into work groups. Small classes encourage trainee involvement through discussion and group
participation and through sharing of knowledge and experiences.
In-Person Training. Outreach training must be done in-person, unless you receive an exemption. If
you’re considering using non-live methods, such as on-line or video conferencing, contact the OSHA
Outreach coordinator at outreach@dol.gov. OSHA has specific on-line training guidelines, and we’ve
only accepted a few on-line programs. The on-line guidelines include the following:
- testing and reporting test scores for each topic and a final
- removal of anyone scoring less than 70 percent after three tries on any program topic
- mandatory page views of each content page
- easy trainer availability built into the system
- printable online materials for each topic
- the course must be interactive
- tracking students’ time in the course, and building in a time out mechanism
- providing required reports and evaluations
The guidelines for video conferencing are as follows:
- the trainer can ensure the full attendance of all trainees,
- off-site locations have a training monitor, and
- there is a setup to answer trainee questions quickly and effectively.
You also must explain what materials, in general, you are providing to the students. You must
provide your students with at least a fact sheet on each topic you cover. Contact your Outreach
Coordinator (Attachment B) prior to the video conference to address the above areas and receive
permission.
10 + 20 Hours = 30. If a student you trained in the 10-hour course wants
to take the 30-hour course at a later time, you may provide 20 more training hours and receive a
30-hour card for the trainee. The limitations are as follows:
- the same trainer must do all the training
- all the training must be completed, from start to finish, within six months
You must return the 10-hour cards to receive the 30-hour cards.
Combined 10-hour Outreach Class. You may not receive 10-hour student cards
for two different Outreach Training Programs (for example, Maritime, and Construction) when holding a
class for less than 20 full hours.
Advertising. When advertising outreach training you must take the proper care to correctly describe
your outreach trainer designation and outreach courses. Trainer authorization is limited to
conducting the 10- and 30-hour Maritime Industry outreach training courses.
Follow these restrictions when advertising your Maritime Industry Outreach Training Program courses.
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Neither the trainer, the students, nor
the curriculum is certified or approved. The trainer is authorized and the students receive
course completion cards.
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You can use the term “OSHA” in your
ads, but don’t make it appear that you’re an OSHA employee or that the course is being conducted
by OSHA. |
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You can’t conduct the #5400 course.
Don’t refer to your outreach course as a #5400 course. The #5400 course is the trainer course
that is conducted by OTI and the OTIECs.
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Don’t use the logo that is on the outreach cards or
the front cover of this guide.
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Don’t combine the use of “OSHA” and
“Train-the-Trainer” in your advertising. Students who complete outreach training aren’t entitled
to receive cards for students they may train.
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If we notify you that your advertising appears false or misleading and you do
not correct it, we will remove you from the Outreach Training Program.
Monitoring. Staff from the OSHA Directorate of Training and Education periodically attend outreach
training classes to observe training, obtain feedback from the trainer and the students on the
training, and ensure awareness of the outreach guidelines and the materials and assistance that are
available to help trainers. Through these visits we aim to help trainers, improve the outreach
training program, ensure consistent program implementation, and assist the trainer in designing the
class to meet the needs of the audience. Let us know about your outreach classes if you’d welcome
our visit.
OUTREACH TRAINING TIPS
Worker Emphasis. Outreach classes are designed to be presented to workers, therefore they must
emphasize hazard identification, avoidance, control and prevention, not OSHA standards. Trainers
must tailor their presentations to the needs and understanding of their audience.
Training Purpose. Explain early in the class that this training isn’t a
bureaucratic exercise – that it may save their life and help them continue to provide for their
family. Explain that safety and health add value to the company, the workplace and their life.
See OSHA's $afety
Pays Program.
Importance of Safety and Health. Early in the your training class,
instill in the audience that safety and health add value. To do this, use local stories that they
will recognize, personal experiences, injury and fatality statistics, and OSHA Fatal Facts. For
more information, see the Further Assistance section.
Site-Specific Training. The most rewarding classes for students are the
ones they can relate to because the trainer uses examples, pictures, and real-life scenarios from
their work place, or one similar to it.
Homogenous Class. The ideal class is one where students have similar
positions and needs. Hold separate sessions for supervisors, managers, and workers, if possible.
Try to train workers from similar groups. For example, trade groups, office personnel, machine
operators, and maintenance staff.
Train Workers in Their Language. Ensure that you know your audience,
including whether there are language barriers. To the extent possible, teach non-English speaking
workers separately. Use translators, easy to understand photos, videos in their language, and
hands-on activities. Also emphasize real-life examples. OSHA and the Outreach Training Program
have Spanish trainers, references, publications, dictionaries and e-tools available at www.osha.gov.
See the Further Assistance section for additional details.
Use Objectives. Describe the skills and abilities the students should have
or exhibit for each topic. Relate the objectives to the students’ work, if possible.
Presentation Assortment. Students learn in different manners, and get tired
of one training style. Use different trainers, computer presentations, videos, case studies, exercises
and graphics to make the course interesting and enjoyable. By doing this you’ll be employing the three
levels of training techniques - presentation (presenting the material in a variety of ways), discussion
(getting the students involved in the learning), and performance (students practice the material they
learned).
Testing. We recommend using quizzes and tests to ensure students remain focused
and understand key objectives. You may set passing scores. Provide feedback to the students on the exam
questions.
Evaluations. OSHA recommends having students complete an evaluation of your
class. This feedback will help you determine whether the course is accomplishing its goals and provide you
input that you can use to improve the training.
The 10-hour program is intended to provide a variety of Maritime safety and health training to entry
level workers. Tailor your training to the type of Maritime students you are teaching – shipyard,
marine terminals or longshoring. The 10-hour classes are intended for workers, therefore the
training should emphasize hazard identification, avoidance, control and prevention, not standards.
Instructional time must be at least 10 hours.
The 10- hour student courses are numbered and named as follows:
10-Hour |
Name |
7615 |
Shipyard Employment, including ship repairing, shipbuilding,
shipbreaking |
7617 |
Marine Terminals |
7618 |
Longshoring |
Of the below topics, three hours are mandatory (seven for 7615 course), choose
four hours from the optional list (one for 7615 course), and fill the remainder of the time from the electives.
Tier 1: Mandatory
- 1 hour each topic
- 7 hours – Shipyards (7615)
- 3 hours – Other Maritime (7617 & 7618) |
Tier 2: Optional
- 1 hour each topic
- 1 hour – Shipyards (7615)
- 4 hours – Other Maritime (7617 & 7618) |
Tier 3: Electives
- 2 hours – Shipyards
- 3 hours – Other Maritime |
Introduction to OSHA, including:
- OSH Act, General Duty Clause, Employer and Employee Rights and Responsibilities,
Whistleblower Rights, Recordkeeping basics
- CFR Part 1903
- Inspections, Citations, and Penalties
- Value of Safety and Health
- OSHA Website and available resources
- OSHA 800 number
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Walking and Working Surfaces
1915 Subpart E, 1917 Subpart F,
1918 Subpart C and D
Personal Protective Equipment
1915 Subpart I, 1917 Subpart E,
1918 Subpart J
*Required – for Shipyards (7615)
Fall Protection / Scaffolding
1915 Subpart E
Electrical
1915 Subpart L, 1910 Subpart S
Confined and Enclosed Spaces
1915 Subpart B
Fire Protection
1915 Subpart P
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Hazard Communications /
Hazardous Materials
1915.1200 Subpart Z
1917 Subpart B
1918 Subpart L
Lockout / Tagout
1915 Subpart L, 1917.48, 1917.49, 1917.151
Respiratory Protection
1910.134
*Optional –
Other Maritime (7617 & 7618)
Fall Protection
1917 Subpart F, 1918 Subpart D and H
Electrical
1915 Subpart L, 1910 Subpart S
Confined and Enclosed Spaces
1917.23, 1918.94 (1910.146)
Fire Protection
1917 Subpart B, 1918 Subpart I |
Hot Work - Welding, Burning & Cutting
1915 Subpart D
1917.152 Subpart G
Material Handling
1915 Subpart G, 1917.50,
1918 Subparts B and F
Bloodborne Pathogens
Exposure Plan
Universal Precautions
Spills and Decontamination
Machine Guarding
1917.151 Subpart G
1910 Subpart O
Ergonomics and Proper Lifting Techniques
Repetitive motion and muscle strains
Additional Coverage
- on Tier 1 or 2 topics
- on any other Maritime industry standards or policies
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The 30-hour program is intended to provide a variety of training to people with some safety
responsibility.
Of the below topics, six hours are mandatory (fourteen for 7635 course), choose eight hours from the
optional list (two the 7635 course), and fill the remainder of the time from the electives.
The 30-hour student courses are numbered and named as follows:
10-Hour |
Name |
7635 |
Shipyard Employment, including ship repairing, shipbuilding,
shipbreaking |
7637 |
Marine Terminals |
7638 |
Longshoring |
MANDATORY TOPICS – at least 6 hours (14 for Shipyard -
7635) |
- Introduction to OSHA - at least Two Hours
- OSH Act, General Duty Clause, Recordkeeping basics
- Employer and Employee Rights and Responsibilities, Whistleblower Rights
- CFR Part 1903; Inspections, Citations, and Penalties; Value of Safety and Health
- OSHA Website; OSHA 800 number and available resources
- Walking & Working Surfaces-at least Two Hours; 1915 Subpart E, 1917 Subpart F, 1918 Subpart C & D
- Personal Protective Equipment - at least Two Hours; 1915 Subpart I, 1917 Subpart E, 1918 Subpart J
Required – for Shipyards - 7635 (Optional for Other Maritime – 7637 & 7638)
- Fall Protection / Scaffolding - at least Two Hours, 1915 Subpart E
- Electrical - at least Two Hours; 1915 Subpart L, 1910 Subpart S
- Confined and Enclosed Spaces - at least Two Hours; 1915 Subpart B
- Fire Protection - at least Two Hours; 1915 Subpart P
OPTIONAL TOPICS – at least 8 hours (2 for Shipyard - 7635) |
- Above four topics for Other Maritime (7637 & 7638) – Fall Protection (1917 Subpart F, 1918
Subpart D and H); Electrical (1915 Subpart L, 1910 Subpart S); Confined and Enclosed Spaces
(1917.23, 1918.94); Fire Protection (1917 Subpart B, 1918 Subpart I)
- Hazard Communications / Hazardous Materials - 1915.1200 Subpart Z, 1917 Subpart B, 1918 Subpart
L
- Lockout / Tagout - 1915 Subpart L, 1917.48, 1917.49, 1917.151
- Respiratory Protection - 1910.134
- Hot Work - Welding, Burning & Cutting, 1915 Subpart D, 1917.152 Subpart G
- Material Handling, 1918 Subpart B, 1918 Subpart F
- Bloodborne Pathogens - Exposure Plan, Universal Precautions, Spills &Decontamination
- Machine Guarding - 1917.151 Subpart G, 1910 Subpart OSHA
- Ergonomics and Proper Lifting Techniques - repetitive motion, muscle strains
- Additional Coverage on Mandatory or Optional topics or any other Maritime industry standards or
policies
FURTHER ASSISTANCE
Main OSHA Web Sites
- OSHA Home Page
-
OSHA Outreach Training Program Page. The site includes:
- Teaching Aids, including the 10-hour PowerPoint you received in the trainer class
- Program Guidelines
- How to get OSHA student course completion cards
- Frequently Asked Questions (FAQs)
- Special Announcements
OSHA Teaching / Materials Assistance Web Sites
Maritime Industry and Training Web Sites
OSHA Publications.
OSHA has many helpful publications, forms, posters, and fact sheets.
Publications are available in HTML and PDF formats. Publications may also be available from the
nearest OSHA Area or Regional Office. A few significant publications are noted below.
- All About OSHA, OSHA 3302.
- Shipyard Industry, OSHA 2268.
- Longshoring Industry, OSHA 2232.
- Traffic Safety In Marine Terminals, OSHA 3337-07.
- OSHA Publications and Audiovisual Programs, OSHA 2019.
- Training Requirements in OSHA Standards and Training Guidelines, OSHA 2254.
- OSHA Handbook for Small Businesses, OSHA 2209. Assists small business employers in implementing
OSHA’s recommended safety and health program management guidelines.
OSHA Quick Cards.
Students will benefit from these cards, many of which are available in both English and Spanish.
These are straightforward reference materials which focus on specific safety and health topics.
U.S.
Government Bookstores. These bookstores sell OSHA standards and publications.
Active Outreach Trainer Lists. If you’re looking for 10-or 30-hour
Maritime training or if you need training assistance, contact the applicable OSHA Education Center
Outreach Coordinator (Attachment B) for a list of active Maritime Industry trainers (two or more
classes conducted the past year). To obtain a list(s) provide:
- State(s) you are looking for (up to three)
- Whether you want the list(s) for Maritime (and/or Construction or General Industry)
- Your e-mail, fax number or mailing address
OSHA Technical Support. For support related to enforcement and the OSHA standards, contact the
Regional Office, or the Area Office near you. These offices also provide publications and other
helpful references. At the Regional Office, ask
for technical support.
OSHA also has Compliance
Assistance Specialists in each Area Office in states under federal
jurisdiction. They’re available for seminars, workshops, and speaking events.
Outreach Contacts
- OSHA Outreach Training Program Coordinator. For online training information and help on matters
that are not found in this guide or at the OSHA web site, including annual PowerPoint charts on
OSHA's Most Frequently Cited Serious Violations in Construction or General Industry, contact:
Don Guerra,
(847) 759-7735
- OSHA Education Centers. For matters relating to general program administration, contact your
representative from the organization responsible for your training. The contact list is at
Attachment B.
- Resource Center Loan Program. For further information on borrowing videos through this program,
contact the OSHA librarian at (847) 759-7736..
PROGRAM ADMINISTRATION
Obtaining Student Course Completion Cards
After conducting an outreach class, follow the instructions below to document your class to the
responsible training location (Attachment B) to receive OSHA student course completion cards.
For each outreach class, send the following:
1. OSHA Outreach Training Program Report.
This includes trainer and course information. Use our format or create your own. Provide an address
that goes directly to you, because we can’t replace card packages that are not received. An excerpt:
Primary Trainer Course Information
______1______ |
____________________________ |
_____2_____ |
__ /_3_ /___ |
ID Number* (see note below) |
Name |
Course (5400/5402) |
Expiration Date |
*ID number – new trainers do not have one - this only applies to trainers who have
received student cards |
1 ID - doesn’t apply to new trainers. Only trainers who have received student cards have one.
2 Course - The most recent course (5400 or 5402) you took.
3 Trainer expiration date (four years after the last course taken).
ID and Associated Information:
- Applies only to trainers who have received student cards.
- If your most recent Maritime Industry expiration date is not reflected on the preprinted report
form, write in the last Maritime Industry trainer course (#5400 or #5402) you took, the expiration
date of that training, and provide a copy of your course certificate or trainer card.
- Trainers with ID numbers may use one of the shortcut formats in
Attachment C.
- If you misplaced your ID number, note on the report that you have one but misplaced it.
2. A copy of your OSHA trainer card if:
- This is your first Maritime Industry outreach training class, or
- You have a new expiration date, because you took a more recent trainer course than the one
shown on your preprinted Outreach Training Program Report.
3. Student Names. Must be legible. We only need one list – do not send in
all the sign-in sheets.
4. Topic Outline. List the topics taught and the amount of time spent on
each. For 10-hour classes, complete the topic outline on the bottom of the report format or send a
separate outline. For 30-hour classes, send a separate outline.
** Submittals that do not include items 1 – 4 may be returned ** |
Remember these key points when submitting your documentation:
- You must document and request cards within six months of class completion.
- Send separate documentation for each class.
- Inform us of special training activities or measured workplace improvements from your training.
Mail, fax, or e-mail your student card requests
Records. Keep class files for 5 years. The file for each class should
include the topic outline, student names, and a copy of the documentation you sent to request cards.
Information on Student Course Completion Cards
- Student cards expire five years after the training. To retain a valid 10- or 30-hour Maritime
Industry card, students are required to take an update course within the five year period.
- Although participation is voluntary, OSHA recommends Outreach Training Program courses as an
orientation to occupational safety and health for workers. Workers must receive additional
training on specific hazards of their job.
- Processing card requests takes two to four weeks. Please wait this amount of time before
inquiring about the status of a request.
- Trainers complete student cards by printing or typing:
- Student’s name
- Course end date
- Expiration date – five years after the course end date
- Your name. You may also sign the card, but you must print or type your name.
- Use Avery 5371 label style to print on the cards. Practice by using a copy of the card sheet.
Feed one sheet at a time.
- You may laminate the cards.
- You may use the back of the cards for other identification or training information, especially
if you have taught a special type of outreach training program. You may list the OSHA Education
Center where you receive your cards – this may help if a student needs a replacement card.
- You may provide a training certificate to your students. This often helps them prove that they
took the training prior to receiving their card. Advertising restrictions also apply here.
- Trainers are sent a few extra cards for each class completed in case of card errors or to
enable you to replace lost student cards for students you trained.
Replacing Lost, Damaged, or Misprinted Cards
Trainer Cards: Contact the organization (Attachment
B) where you took the course.
Student Cards: We rarely replace a batch of cards from an entire class. For individual
replacements, use the extra cards provided to you, after you make the proper verification. If you
don’t have an extra card, contact your responsible organization (Attachment B) for a replacement.
Provide them the student’s name, your name, the training date, and the type of class (10 or
30-hour, construction or general industry). Records are kept for five years plus the present year.
If the training took place prior to this, we can’t issue a new card.
Misprinted Cards: Return all misprinted cards for replacements.
Course
Conducted:
□ 10-Hour 7615 – Shipyards
□ 10-Hour 7617 – Marine Terminals
□ 10-Hour 7618 – Longshoring
□ 30-Hour 7635 – Shipyards
□ 30-Hour 7637 – Marine Terminals
□ 30-Hour 7638 – Longshoring |
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Course Information
(check all that apply):
□ Spanish |
□ Youth (age 18 or less) |
□ Language other than Spanish |
□ Training conducted outside US |
□ OSHA Alliance or Partnership related (specify
below)
___________________________________________________________ |
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State where training held (or country if outside of US): _______________________________
Course End Date: _____ / _____ / ________ (We can’t accept requests that are older than 6 months)
Number of Students: __________ (More than 50 requires prior permission)
Primary Trainer Course Information
____________ |
____________________________ |
___________ |
__ /__ /____ |
ID Number* (see note below) |
Name |
Course (5400/5402) |
Expiration Date |
*ID number – new trainers do not have one - this only applies to
trainers who have received student cards |
Address: Use an address that will get directly to you. (If
you have an ID and your address is the same, don’t complete this)
□ Check if this is a new address
Company / Dept. __________________________________________________________
Address _________________________________________________________________
________________________________________________________________________
City/State/Zip ____________________________________________________________
Phone No: (_____) - _____ - _______ ext. ______ Best time(s) to call:____________
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Your documentation must include:
(1) Outreach Training Program Report
(2) Copy of trainer card if this is your 1st class or you have taken new trainer training
(3) Student names
(4) Topic list and the time spent on each |
Also remember:
* Send separate documentation for each class
* See Attachment B for where to send card request
* Print or type trainer’s name on card to ensure legible
* Use Avery 5371 label style to print on the cards |
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10 Hour Maritime Industry Topics (for 30-hour class, include a
separate topic list) |
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HOURS
(Indicate the amount of time spent on each of the topics)
_____ Required Introduction to OSHA
_____ Required Walking and Working Surfaces
_____ Required Personal Protective Equipment
_____ (Shipyards) Required Fall Protection / Scaffolding
_____ (Shipyards) Required Electrical
_____ (Shipyards) Required Confined and Enclosed Spaces
_____ (Shipyards) Required Fire Protection
Optional
_____ Hazard Communications / Hazardous Materials
_____ Lockout / Tagout
_____ Respiratory Protection
_____ (non Shipyards) Fall Protection
_____ (non Shipyards) Electrical
_____ (non Shipyards) Confined and Enclosed Spaces
_____ (non Shipyards) Fire Protection |
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Electives
_____ Hot Work – Welding, Burning & Cutting
_____ Material Handling
_____ Bloodborne Pathogens
_____ Machine Guarding
_____ Ergonomics and Proper Lifting Techniques
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Other Maritime Standards or Policies
________________________________________
________________________________________
________________________________________
________________________________________
________________________________________ |
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The OSHA Training Institute has authorized these educational institutions to
conduct selected OSHA courses, including:
Course 5400 OSHA Trainer Course for the Maritime Industry
Course 5402 Update for Maritime Industry Outreach Trainers
Education Centers |
Lead Center: City/State |
Phone |
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Keene State College
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Manchester, NH |
800-449-6742 |
Rochester Institute of Technology
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Rochester, NY |
866-385-7470x2919 |
Atlantic OSHA Training Center |
New Brunswick, NJ |
732-235-9450 |
(Univ. of Medicine & Dentistry of NJ, State University of New York at Buffalo, Universidad
Metropolitana, San Juan, PR)
|
National Resource Center for OSHA Training |
Morgantown, WV |
800-626-4748 |
(West Virginia University, National
Labor College, Building and Construction Trades Dept., , Center to Protect Workers’ Rights)
|
Keystone Occupational Safety and Health Center |
Indiana, PA |
800-640-7421 |
(Indiana University of Pennsylvania)
|
|
|
Georgia Tech Research Institute
|
Atlanta, GA |
404-385-3500 |
University of South Florida
|
Tampa, FL |
866-697-0975 |
Eastern Kentucky University
|
Richmond, KY |
877-358-6742
|
Great Lakes OSHA Training Consortium |
Cincinnati, OH |
800-207-9399 |
(Univ. of Cincinnati, Eastern
Michigan University, United Auto Workers)
|
The National Safety Education Center |
Chicago area, IL |
800-656-5317 |
(Northern Illinois University,
Construction Safety Council, National Safety Council)
|
Mid-America OSHA Training Institute |
Springboro, OH |
866-444-4412 |
(Ohio Valley Construction Education
Foundation, Sinclair Community College)
|
Texas Engineering Extension Service, Texas A & M University
|
Mesquite, TX |
800-723-3811 |
Metropolitan Community Colleges - Business & Technology Center
|
Kansas City, MO |
800-841-7158
|
Midwest OSHA Education Centers |
Cedar Rapids, IA |
800-464-6874 |
(Kirkwood Community College, St.
Louis University, Safety and Health Council of Greater Omaha)
|
Red Rocks Community College
|
Lakewood, CO |
800-933-8394 |
Mountain West OSHA Training & Outreach Center |
Salt Lake City, UT |
801-581-4055 |
(University of Utah, Salt Lake City
Community College)
|
University of California - San Diego
|
San Diego, CA |
800-358-9206
|
WESTEC, Westside Energy Services
|
Taft, CA |
866-493-7832
|
University of Washington |
Seattle, WA |
800-326-7568 |
WHERE: See the following pages on where and how
(mail, e-mail, fax) to submit requests.
QUESTIONS: See the below list
PROGRAM ADMINISTRATION:
Send in:
- OSHA Outreach Training Program report
- Copy of Maritime Industry trainer card if this is your first request or if you’ve taken new
trainer training
- Student names
- Course topic list and the time spent on each
Requests are reviewed to ensure:
- Trainer is currently authorized
- Complies with guidelines (topics, time, etc.)
- Documentation is complete
WHERE – Specifics
This list is organized by OSHA Regions 1-10. Here are the Regional Office locations in each of the
regions.
1 – Boston
6 - Dallas |
2 – New York
7 – Kansas City |
3 – Philadelphia
8 – Denver |
4 – Atlanta
9 – San Francisco |
5 – Chicago
10 – Seattle |
Region 1 – Northeast, including NH, ME, RI, MA, CT, VT |
If you took the training from
- OTI Education Center at Keene State College, Manchester, NH
- OTI Education Center at Keene State College, Keene, NH
- Associated Builders and Contractors, Rock Hill, CT
- Survival System USA, Groton, CT
- University of New Haven, West Haven, CT
- Associated General Contractors of Mass., Wellesley, MA
- Janus Training Center, Lawrence, MA
- Central Maine Community College, Auburn, ME
- Maine Dept. of Transportation, Fairfield, ME
- Occupational & Environmental Health Center of RI, Providence, RI
- Roger Williams University, Portsmouth, RI
- Associated General Contractors of Vermont, Montpelier, VT |
Send your card requests to
OSHA Training Institute Education Center
Keene State College
175 Ammon Drive
Manchester, NH 03103-3308
For questions: (800) 449-6742
Leslie Singleton
|
Region 2 – Northeast, including NJ, NY, and Puerto
Rico |
If you took the training from
- Univ. of Medicine and Dentistry of NJ, New Brunswick, NJ
- State Univ. of New York at Buffalo, Toxicology Research Center, Buffalo, NY
- Universidad Metropolitana, San Juan, PR |
Send your card requests to
UMDNJ- School of Public Health
Attn: Janet Crooks, Registrar
Atlantic OSHA Training Center
Office of Public Health Practice
683 Hoes Lane West, 1st Floor
Piscataway, NJ, 08854
For questions:
Koshy Koshy, (732) 235-9459
Janet Crooks, (732) 235-9455 |
Region 2 – New York |
If you took the training from
- Rochester Institute of Technology OSHA Education Center, Rochester, NY
- Rochester Builder’s Exchange, Rochester, NY
- General Building Contractors’ Safety Training Facility in Spencerport, NY and Albany, NY
- Total Safety Consulting, Long Island City, NY
- Oneida Indian Nation Building Annex, Oneida, NY |
Send your card requests to
Rochester Institute of Technology OSHA Education Center
Attn: Donna Winter
31 Lomb Memorial Dr.
Rochester, NY 14623-5603
- Fax: (585) 475-6292
- email
|
For questions:
Donna Winter (866) 385-7470 ext. 2919 |
Region 3 – Pennsylvania |
If you took the training from
- Indiana University Training Center, Monroeville, PA
- High Training Center, Lancaster, PA
- Wilkes University, Wilkes Barre, PA
- Indiana University of Pennsylvania, Indiana, PA
- Graduate Business Center, West Chester University, West Chester, PA
- Montgomery County Public Safety Training Campus Fire Academy, Conshohocken, PA (Philadelphia)
- Dixon Center, Harrisburg, PA
- New Castle School of Trades, New Castle, PA
- Bedford County Workforce Development and CE Center, Everett, PA
- Lucerne County Community College, Nantycoke, PA |
Send your card requests to
IUP School of Continuing Education
Keith Hall Suite #100
390 Pratt Drive
Indiana, PA 15705-1014
For questions:
Kathy Evanko
(724) 357-2227 or (800) 640-7421 |
Region 3 – East and Building Trades, including WV,
MD, PA, VA, DC |
If you took the training from
National Labor College
- College Park, MD; Philadelphia PA; Silver Spring MD;
Washington DC; Wilkes-Barre PA, Harrisburg PA, Richmond VA & Roanoke VA
- and other organizations, unions, and companies served with special programs or on-site
training |
Send your card requests to
National Labor College
10000 New Hampshire Avenue
Silver Spring, MD 20903
- Fax: (301) 431-5411
- email: Sandra Tillett
- Questions:
Jamal Brown, Sandra Tillett
(800) 367-6724
|
|
Center to Protect Workers' Rights/BCTD
- Building and Construction Trades Unions
- Building and Construction Trades Councils
- Building and Construction Trades Contractors |
Center to Protect Workers' Rights
815 16th Street NW
Washington, DC 20006
- Fax: (202) 756-4675
- email: Janice Wheeler
- Questions:
Janice Wheeler (202) 756-4636
|
|
West Virginia University
- Morgantown, WV
- Charleston, WV
- Huntington, WV
- Operating Engineers, Beckley, WV
- Contractors Association, Parkersburg, WV
- Pittsburgh, PA
- Richmond, VA
- and other safety councils, organizations, and companies served with on-site training |
West Virginia University
Safety & Health Extension
P. O. Box 6615 - 130 Tower Lane
Morgantown, WV 26506
- Fax: (304) 293-5905
- email: Missy Stewart
- Questions:
Tom Stockdale (800) 626-4748
|
|
Region 4 – South, including GA, NC, SC, MS, KY, AL,
FL, TN |
If you took the training from
- Georgia Tech / Georgia Institute of Technology, Atlanta, GA
- Georgia Tech OTI Education Center in these cities:
GA – Atlanta, Savannah
FL - Orlando, Ft. Lauderdale, Destin, Jacksonville
NC – Raleigh
AL – Birmingham, Huntsville
SC - Charleston
MS - Biloxi
TN – Nashville, Knoxville, Memphis |
Send your card requests to
Georgia Tech OTI Education Center
ATTN: Diane Knobloch
430 Tenth Street, NW
Atlanta, GA 30332-0837
For questions:
Diane Knobloch (404) 407-7024
Myrtle Turner (404) 407-8066 |
Region 4 – Florida |
If you took the training from
University of South Florida, Tampa, FL
Host Training Sites:
- Associated Builders and Contractors, Orlando, FL
- Caribbean Legal and Professional Institute, Kingston, Jamaica
- Indian River Community College, Fort Pierce, FL
- Florida International College, Fort Myers, FL
- Florida Safety Council, Orlando, FL
- North East Florida Safety Council, Jacksonville, FL
- Safety Council of Palm Beach County, West Palm Beach, FL
- Safety Management Internatl Co., Couva, Trinidad, West Indies
- Suncoast Safety Council, Clearwater, FL
- Suncoast Safety Council, St Petersburg, FL
- Sunshine Safety Council, Daytona, FL |
Send your card requests to
University of South Florida OTI Education Center
ATTN: Diane Ray
13201 Bruce B. Downs Blvd., MDC 56
Tampa, FL 33612-3805
- Fax: (813) 974-9972
- email
|
For questions:
Diane Ray (813) 974-7782 |
Region 4 – Kentucky |
If you took the training from
- Eastern Kentucky University, Richmond, KY
- McCulley, Eastham & Associates, Inc., Greenup, KY
- Corbin Center for Technology and Community Activities, Corbin, KY |
Send your card requests to
Bobby Spurlock
Eastern Kentucky University
OSHA Training Institute Education Center
Workforce Education
521 Lancaster Ave, Perkins 202
Richmond, KY 40475-3100
- email
- For questions: (859) 622-6216
|
|
Region 5 – Midwest, especially IL and WI, IN |
If you took the training from
- NIU-DeKalb, IL
- NIU-Naperville, IL
- NIU Education Center, Hoffman Estates, IL
- NIU Rockford Center, Rockford, IL
- National Safety Council, Itasca, IL
- Construction Safety Council, Hillside, IL
- Richland Community College, Decatur, IL
- Northeast Wisconsin Technical College, Green Bay, WI
- Fox Valley Technical College, Appleton, WI
- Dawson Technical Institute, Chicago, IL
- University of Southern Indiana, Evansville, IN
- and other safety councils, organizations, and companies served with on-site contract training. |
Send your card requests to
The National Safety Education Center
College of Engineering & Engineering Technology
Northern Illinois University
590 Garden Road, EB 318
DeKalb, IL 60115
For questions:
(815) 753-6902 or (800) 656-5317, or
email |
Region 5 – Midwest, including OH, MI, MN, IN, WI |
If you took the training from
- University of Cincinnati, Cincinnati, and Columbus, OH
- Kent State University, Canton, OH
- Eastern Michigan University, Livonia, MI
- Eastern Michigan University-Web Based Training
- M-TEC, Kalamazoo, MI
- University of Findlay, Findlay, OH
- University of Minnesota, Minneapolis, MN
- South Central Tech, Mankato, MN
- Lake Shore Technical College, Cleveland, WI
- Indiana University Southeast, New Albany, IN
- Purdue University North Central, Indianapolis IN |
Send your card requests to
Great Lakes Regional OTI Education Center
ATTN: Marianne Kautz
Genome Research Institute
University of Cincinnati
2180 E. Galbraith, 3rd Floor
Cincinnati, OH 45237-1625
For questions:
Marianne Kautz
(800) 207-9399 or (513) 558-1730 |
Region 5 – Midwest, including OH, MI, MN, IN, WI |
If you took the training from
Mid-America OSHA Education Center, Springboro, OH |
Send your card requests to
Mid-America OSHA Education Center
ATTN: Susan White
33 Greenwood Lane
Springboro, OH 45066
For questions:
(937) 521-1570 or (866) 444-4412 |
Region 6 – South, especially TX, and NM, LA, OK, AR |
If you took the training from
- TEEX – North Texas Regional Training Center, Mesquite, TX
- TEEX – Houston Regional Training Center, Houston, TX
- TEEX – South Central TX Reg’l Training Center, San Antonio, TX
- TEEX – Corpus Christi Regional Training Center, Corpus Christi, TX
- TEEX – South Presa Training Center, San Antonio, TX
- TEEX – Marine Safety Center, Galveston, TX
- State of New Mexico Occup. Health & Safety Bureau, Santa Fe, NM
- Safety Counseling Inc., Albuquerque, NM
- Safety Matters, Albuquerque, NM
- Acadian Integrated Solutions, Maurice, LA
- U.S. Army Safety Center, Ft. Rucker, AL
- U.S. Air Force Safety Center, Albuquerque, NM
- Francis Tuttle Tech. Center, Oklahoma City, OK
- NATCO Training Center, Midland, TX
- Pioneer Tech. Center, Ponca City, OK
- National Park Community College, Hot Springs, AR
- Texas State Tech. College, Harlingen, TX
- TAMU – Corpus Christi, TX
- KTech, Inc., Albuquerque, NM
- Eastern New Mexico University, Roswell, NM
- CEHMM, Carlsbad, NM
- Permian Basin Regional Training Center, Carlsbad, NM
- United Space Alliance, Houston, TX
- San Juan College, Farmington, NM
- Arkansas Construction Education Foundation, Little Rock, AR
- Bossier Parish Community College, Shreveport, LA
- Alford Safety Services, Houma, LA
- Del Mar College, Corpus Christi, TX
- David Carrasco Job Corp Center, El Paso, TX
- New Mexico State University, Las Cruces, NM |
Send your card requests to
OTI Southwest Education Center
Texas Engineering Extension Service
ATTN: Registrar
15515 IH 20 at Lumley
Mesquite, TX 75181
- Fax: (972) 222-2978
- email
|
For questions:
Therese Paterka or Pam Pendleton
(972) 222-1300 or (800) 723-3811 |
Region 7 – Missouri |
If you took the training from
- Metropolitan Community College, Kansas City, MO
- Maple Woods Community College, Kansas City, MO
- Business & Technology Center, Kansas City, MO |
Send your card requests to
Region VII OTI Education Center
Metropolitan Community Colleges
ATTN: Dick Day, Program Manager
1775 Universal Avenue
Kansas City, MO 64120
For questions:
Dick Day
(816) 482-5282 |
Region 7 – Midwest, including MO, IA, NE |
If you took the training from
- Saint Louis University, St. Louis, MO
- Saint Louis University, Springfield, MO
- Kirkwood Community College, Cedar Rapids, IA
- National Safety Council, Omaha, NE |
Send your card requests to
Kirkwood Community College
Midwest OSHA Education Center
ATTN: Marsha Willox
6301 Kirkwood Blvd. SW
Cedar Rapids, IA 52406
- Fax: (319) 398-5894
- email
• On-line request form at: http://moec.kirkwood.edu/
|
For questions:
-- Marsha Willox (319)398-5893
-- Edgar Thornton (319)398-1029 |
Region 8 – Mountain, especially Colorado, and also
UT, MT |
If you took the training from
- Rocky Mountain Education Center, Lakewood, CO
- Red Rocks Community College, Lakewood, CO
- Ogden Weber Applied Technology College, Salt Lake City, UT
- Montana Dept of Labor and Industry Occupational Safety & Health Bureau, Missoula, MT |
Send your card requests to
Rocky Mountain Education Center
ATTN: Jeannine Kreller
13300 W. 6th Ave, Box 41
Lakewood, CO 80228-1255
For questions:
Jeannine Kreller (800) 933-8394 |
Region 8 – Utah |
If you took the training from
- Mountain West OSHA Training and Outreach Center, Salt Lake City, UT
- Salt Lake Community College, Salt Lake City, UT |
Send your card requests to
Mountain West OSHA Training and Outreach Center
University of Utah
ATTN: Registrar
391 Chipeta Way, Suite C
Salt Lake City, UT 84108
- Fax: (801) 585-5275
- email
|
For questions:
-- Connie Crandall
(801)581-7182
-- Luz Dominguez
(801)581-7909 |
Region 9 – West, especially CA, and also NV, HI, and
AZ |
If you took the training from
University of California, San Diego
OSHA Training Institute in Region IX
- Arizona
- California
- Hawaii
- Nevada
|
|
Send your card requests to
UCSD OSHA Training Institute
ATTN: Outreach Training Coordinator
11770 Bernardo Plaza Court, Suite 270
San Diego, CA 92128
For questions:
email
(858) 485-5371 |
Region 9 – West, especially CA, also NV and Guam |
If you took the training from
- WESTEC, North Kern Training Center, Shafter, CA
- Cal State University at Dominguez Hills, Carson, CA
- Community College of Southern Nevada, Henderson, NV
- Truckee Meadows Community College, Reno, NV
- Guam Community College, Mangilao, Guam |
Send your card requests to
WESTEC
Region IX OSHA Training Institute Education Center
ATTN: Craig Bertram
5801 E. Lerdo Hwy.
Shafter, CA 93263
For questions:
Craig Bertram, 661-387-1055 |
Region 10 – West, especially WA, and also OR, ID,
and AK |
If you took the training from
UW/Denali Safety Council – Anchorage, AK
UW – Boise State University - Boise, ID
UW/HVAC Metals Institute – Portland, OR
UW/Portland Community College – Portland, OR
UW/HAMMER Facility – Richland, WA
UW/EnergX Facility – Richland, WA
UW – Seattle, WA
UW – Spokane, WA
UW – Cruise to Alaska |
Send your card requests to
Region X OSHA Training Institute Education Center
University of Washington
ATTN: Registrar
4225 Roosevelt Way NE #100
Seattle, WA 98105
- Fax: (206) 685-3872
- email: Terumi
Capeling
- On-line requests form available at: http://depts.washington.edu/ehce/
|
For questions:
Terumi Capeling, (206) 685-3089 |
ATTACHMENT C
SHORTCUT PROCEDURES
FOR OUTREACH TRAINERS WITH ID NUMBERS
|
Student card requests are accepted by e-mail, fax, and short mail-in
format, if you have an ID number.
*Carefully read the instructions below before using these procedures.
1. Who is Eligible? Outreach Trainers with ID Numbers.
- You receive your ID number in your card package AFTER submitting your first card request.
- Your ID number is provided on the letter or the preprinted Outreach Training Report that are
returned with your student cards.
2. Sending Requests for Student Cards
- E-mail
- See Attachment B for e-mail addresses
- Subject: 10 or 30-Hour Maritime
Industry Outreach Training Program
- Format your e-mail request based on the format which follows these procedures
- Do not send attachments – send all information in the body of your e-mail
- Fax
- See Attachment B for numbers
- Send a cover page and indicate the number of pages you’re sending
- Subject: 10 or 30-Hour Maritime Industry Outreach Training
Program
- Format your fax request based on the format which follows these procedures
- Short Mail-in Format
- See Attachment B for numbers
- Use short mail-in format which follows these procedures
3. Instructions
- Use your ID Number when requesting cards using one of these procedures
- For each class - send a separate e-mail, fax, or mail-in format
- Keep a file on each course which includes:
- Topics taught and time spent on each
- Student names
- A copy of the e-mail or fax you sent to request cards.
4. Monitoring. At times, we may ask for a copy of your training topics.
When we conduct monitoring visits for the OSHA Outreach Training Program, we may ask to see
documentation of the topics and students taught for each outreach training class conducted.
E-Mail Format -
Request for Outreach Training Cards -- For Trainers with ID Numbers
-- Below is a sample of the e-mail format.
-- You have to create the format and include it in the body of your e-mail – don’t send attachments
-- Send a separate e-mail for each class.
==================================================================================
TO: See Attachment B for e-mail address
SUBJECT: |
10 or 30-Hour Maritime
Industry Outreach Training Program |
----------------------------------------------------------------------------------------------------------
Course Information (check all that apply):
__ Spanish
__ Language other than Spanish
__ Youth (age 18 or less)
__ Training conducted outside US
__ OSHA Alliance or Partnership related (specify ___________________________________________ )
State where training held (or country if outside of US): _______________________________
Course End Date: _____ / _____ / ________ (We can’t accept requests that are older than 6 months)
Number of Students: ____________ (More than 50 requires prior permission)
Trainer ID: _________
Trainer Name: _________________________________________
Trainer Course Data:
If the Course information shown on your Outreach Training Report is
incorrect, enter the following information, as applicable:
|
|
Maritime Industry |
__ 5400 __ 5402 |
Training Date ___/___/___ |
Trainer Address / Phone: (Only needed if your address has changed)
Student Names:
_____ (Check) I certify that the topics taught and the time spent on the topics in this class met the
requirements of the OSHA Outreach Training Program.
FAX Format - Request for Outreach Training Cards -- For Trainers with ID Numbers
See Attachment B for Fax numbers
Course: |
□ 10 hour Maritime |
|
|
□ 30 hour Maritime |
|
Course Information (check all that apply):
□ Spanish
□ Language other than Spanish
□ Youth (age 18 or less)
□ Training conducted outside US
□ OSHA Alliance or Partnership related (specify:)__________________________________________
State where training held (or country if outside of US): ___________________________________
Course End Date: _____ / _____ / ________ (We can’t accept requests that are older than 6 months)
Number of Students: ____________ (More than 50 requires prior permission)
Trainer ID: ____________
Trainer Name: _________________________________________
Trainer Course Data: If the Trainer or Update Course information shown on your Outreach
Training Report is incorrect, please enter the following information:
|
|
Maritime Industry |
__ 5400 __ 5402 |
Training Date ___/___/___ |
Trainer Address / Phone: (Only needed if your address has changed)
________________________________________________
________________________________________________
________________________________________________
________________________________________________
I certify that the topics taught and the time spent on the topics
in this class met the requirements of the OSHA Outreach Training Program
_________________________________________ (Sign)
Student Names
1___________________________________ |
11 ___________________________________ |
2___________________________________ |
12 ___________________________________ |
3___________________________________ |
13 ___________________________________ |
4___________________________________ |
14 ___________________________________ |
5___________________________________ |
15 ___________________________________ |
6___________________________________ |
16 ___________________________________ |
7___________________________________ |
17 ___________________________________ |
8___________________________________ |
18 ___________________________________ |
9___________________________________ |
19 ___________________________________ |
10__________________________________ |
20 ___________________________________ |
|
---->> Continue on another page if more students |
Short Mail Format -
Request for Outreach Training Cards -- For Trainers with ID Numbers
See Attachment B for Addresses
Course: |
□ 10 hour Maritime |
|
|
□ 30 hour Maritime |
|
Course Information (check all that apply):
□ Spanish
□ Language other than Spanish
□ Youth (age 18 or less)
□ Training conducted outside US
□ OSHA Alliance or Partnership related (specify:)__________________________________________
State where training held (or country if outside of US): ___________________________________
Course End Date: _____ / _____ / ________ (We can’t accept requests that are older than 6 months)
Number of Students: ____________ (More than 50 requires prior permission)
Trainer ID: ____________
Trainer Name: _________________________________________
Trainer Course Data: If the Trainer or Update Course information shown on your Outreach
Training Report is incorrect, please enter the following information:
|
|
Maritime Industry |
__ 5400 __ 5402 |
Training Date ___/___/___ |
Trainer Address / Phone: (Only needed if your address has changed)
________________________________________________
________________________________________________
________________________________________________
________________________________________________
I certify that the topics taught and the time spent on the topics
in this class met the requirements of the OSHA Outreach Training Program
_________________________________________ (Sign)
Student Names
1___________________________________ |
11 ___________________________________ |
2___________________________________ |
12 ___________________________________ |
3___________________________________ |
13 ___________________________________ |
4___________________________________ |
14 ___________________________________ |
5___________________________________ |
15 ___________________________________ |
6___________________________________ |
16 ___________________________________ |
7___________________________________ |
17 ___________________________________ |
8___________________________________ |
18 ___________________________________ |
9___________________________________ |
19 ___________________________________ |
10__________________________________ |
20 ___________________________________ |
|
---->> Continue on another page if more students |
|
|