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Class Name: OSHA 500 Class Date: (month/day/yr) _____ /_________ /______ Location: (city, state) ________________________________ , _______

Indicate Payment Method: (please check)

Check Enclosed_____ Please Invoice_____ Visa____ Mastercard _____ American Express_____ Discover______

Card #______________________________ CID #:_______ Exp. Date:__________ Name on Card: _______________________________

#4844

Student Name(s): ____________________________________________________________________________________________________

Company: ______________________________________________________________Email: _______________________________________

Address: ____________________________________________________ City, State, Zip: ____________________________________________

Phone #: _____________________________Fax #: _________________________________

Registration Form - Please FILL OUT the Course Info Below:

You can mail this form to:MAOTIEC/Chesapeake Region Safety Council - 2555 Lord Baltimore Drive, Suite N-R, Baltimore, MD 21244

Call to register: 1-800-875-4770 Fax: 410-281-1350 Register online at www.oshamidatlantic.orgMake checks payable to: Chesapeake Region Safety Council

Class Time: 8:00am to 4:00pm Fee: $845

This course is designed for individuals interested in teaching the 10- and 30-hour construction safety and health Outreach Training Program to their employees and other interested groups. Using OSHA Construction Standards as a guide, special emphasis is placed on those topics required in the 10- and 30-hour programs as well as those which are most hazardous. Students are briefed on e�ective instructional approaches and use of visual aids and handouts. This course allows the student to become a trainer in the OSHA Outreach Training Program, to conduct both 10- and 30-hour Construction Outreach classes, and to issue cards to partici-pants after verifying course completion. Students who wish to participate as authorized Outreach trainers in the OSHA Outreach Training Program must prepare a presentation on an assigned OSHA Construction Outreach Training Program topic individually or as part of a group and successfully pass a written exam at the end of the course.

Prerequisites: Students must successfully complete the OSHA #510 Occupational Safety and Health Standards for Construction and have �ve (5) years of safety and health work experience in the construction industry. A degree in occupational safety and health, a Certi�ed Safety Professional (CSP) or a Certi�ed Industrial Hygienist (CIH) designation may be substituted for two (2) years of work related experience. Students should obtain guidance on whether they meet this requirement from the OSHA Training Institute Education Center where they intend to receive the training. Authorized OSHA Outreach Training Program trainers are required to attend OSHA #502 Update for Construction Industry Outreach Trainers at least once every four (4) years to maintain their trainer status.

OSHA #500 Trainer Course in Occupational Safety and Health Standards for the Construction Industry

Call to register: 1-800-875-4770 Register online: www.oshamidatlantic.org

Topics Include:• Safety and Health Programs • Fall Protection • Stairways/Ladders• Fire Protection • PPE • Electrical Standards• Hand & Power Tools • Concrete & Masonry • Cranes, Derricks, Hoists• Material Handling • Evacuation • Con�ned Spaces

Locations & DatesAssociated Builders & Contractors, Inc. (ABC), Central PA ChapterPhysical: 898 N. Eagle Valley Road, Milesburg, PA 16853GPS: 898 N. Eagle Valley Road, Howard, PA 16841● Mar. 23-26, 2020 ● Oct. 12-15, 2020

Butler Community CollegePublic Safety Bldg., Room 206107 College Drive, Butler, PA 16003● Sept. 21-24, 2020

HACC, Central Pennsylvania's Community College Senator John J. Shumaker Public Safety Center (Gate 5)One HACC Drive, Harrisburg, PA 17110● May 11-14, 2020

Luzerne County Community College133 South Prospect St., Nanticoke, PA 18634● Oct. 26-29, 2020

Millersville University - The Ware Center42 North Prince Street, Lancaster, PA 17603● June 8-11, 2020 ● Nov. 2-5, 2020

Northampton Community College - Fowler Center 511 East Third Street, Bethlehem, PA 18015● Jan. 21-24, 2020 ● Mar. 9-12, 2020● June 22-25, 2020 ● Sept. 14-17, 2020● Dec. 7-10, 2020

The Giant Center - Scenic Room315 York Rd., Willow Grove, PA 19090● Feb. 3-6, 2020 ● May 11-14, 2020● July 27-30, 2020

• This course counts toward earning MAOTIEC’s Construction Safety and Health Specialist Certi�cate

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