Ohio Administrative District Council, I.U. of Bricklayers & Allied Craftworkers

                                         

                                             Safety Training Registration Form   
           
· Class DATE, TIME, and LOCATION will be determined when the appropriate      number of registrations have been received or as the Safety Training Schedule    indicates.

· ONLY members of union locals within the jurisdiction of the Ohio Admin. District Council of BAC will be accepted for the provided educational courses unless pre-approved by the OADC Director.
· You may complete the form below and mail or fax the form to the OADC at; 

Ohio Administrative District Council of BAC
5171 Hudson Dr. Hudson, Ohio 44236
Fax: 330-463-5542   Phone: 1-800-442-0479

                                                 
Questions? 
Contact Safety Instructor, Don Mays at 1-330-382-9600 or send a fax or e-mail to

1-330-382-9601
mays@oadc.net


        CHECK THE COURSES BELOW YOU ARE INTERESTED IN ATTENDING

The Ohio Administrative District Council
Safety Class Pre-Registration Form


Check the boxes for the classes you are interested in attending:
                                                                                                                 
[   ]   10 Hour OSHA Construction Health & Safety Training

[   ]   30 Hour OSHA Construction Health & Safety Training

[   ]   Suspension Scaffold / Rigging / Body Harness Hazards, (PART 1)

[   ]   Suspension Scaffold / Rigging, (PART 2), (must have completed the updated PART 1 first)

[   ]   CPR/First Aid/AED                                              [   ]   Steward Training     

[   ]   Respirator Training / Testing                              [   ]   Scaffold Users Training

[   ]   Confined Space / Lock-Out / Tag-Out, (CPWR 16 Hr)   [   ]   OSHA 16 Hour Const.

[   ]   Confined Space / Lock-Out / Tag-Out Awareness, (8 Hr)

Name: ____________________________________________ Local Union# _____________

Address ______________________________________City__________________________

State _______ Zip code__________ Phone ___________________ Cell ________________

I.U. # _________________  Trade ______________________________________________

Email address ______________________________________________________________

If you are registering for a class already scheduled please enter the class and date from the Safety Training Calendar,

  Class: _____________________________________  Date: _________________________