Confirm Your Details

 
 
 
 
 
 

Company Information

 Company Name: 
 Address 1: 
 Address 2: 
 City: 
  Province 
 Postal Code: 
 Phone: 
 Fax: 
 

Applicant Contact Person

 First Name: 
 Last Name: 
 Title: 
 Address 1: 
 Address 2: 
 City: 
  Province 
 Postal Code: 
 Phone: 
 Cell: 
 Fax: 
 Email: 
 

Secondary Contact Information

 First Name: 
 Last Name: 
 Title: 
 Phone: 
 Email: 
  How Many Employees Are In Your Company?  
  How Long Has Your Company Been Offering Safety Training? Years & Months  
  Describe the Training Courses that your company currently offers?  
 

What Programs Will Your Company Be Seeking Accreditation For?

  Elevated Work Platform Yes No  
  Confined Space Yes No  
  Fall Protection Yes No  
  Fire Watch Yes No  
 

Program Development & Delivery:

  What is your company's background in Safety?  
   
  What is your background in Adult Education/Training?  
 
   
  In addition to delivering the training directly, are you planning on using contract instructors? If yes, approximately how many?  
  What type of electronic database do you use, and what are the exporting capabilities and formats ie. xls, .xms, etc.  
  What are the locations that you will be offering training?  
 



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