Training Wish List

(Please Print Legible)

Training Wish List (Please Print Legible)

Today's Date

Municipality Name

Safety Coordinator or Contact

Mailing Address

City, State, Zip

Telephone

Fax

Email

We would like the following training topics for our Municipality

Additional Requests

Our Municipality would like assistance with the following items

OSHA 300 LogSafety & Health Policy/ProgramJHA's (Job Hazard Analysis)Emergency Action Plan*Worker's Comp Safety Audit is required once a year*Other Needs

If other please describe

Special Training Requests to Add to Our Topic List