All registrations must be signed. PRINT THIS FORM OUT FROM YOUR BROWSER or get PDF Registration Click HERE! EMAIL US HendyCompany Super Safety or Chicago Safety Institute |
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Company: _____________________ PO# ___________ Established Accounts attach Original Purchase Order by FAX |
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From: Dave Hendy Trainer Telephone 773-538-3333Intl +1 312 543-6742 |
24Hr Toll Free 800-275-8239FAX this to 773-538-8080 Email See above |
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Billing Address: Chicago Safety Institute PO Box 09282 Stock Yard Station Chicago, Illinois 60609 |
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Chicago: I-90/94 Local Lanes Exit SOuth 47th Street go West to Halsted go North toTraining Location **4551 S. HALSTED CHICAGO, ILLINOIS 60609** East Side of Halsted, Park on Side street 46th for free! |
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We issue THE OSHA Construction 10 & 30 Hour CARD and certification for HAZWOPER for EMERGENCY RESPONDERS. Locations we can train at your site! Modern Facility training by arrangement for our customers always confirm start and scheduled times. Always check please where Location of class is; at 4551 Halsted Chicago Il. or other Locations. HAZWOPER #1 |
1) Nationwide | 2) Services: Safety, & Hygiene Services. | 3) OSHA Authorized Outreach provider, AHA & NSC Community Ctr |
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Desired Dates ___________________ Point Of Contact ________________________________ | |||||||||||||||||||||||||||
40-Hour HAZWOPER ___ |
24-Hour ERT ___ |
Supervisor 8 Hr __ |
8 HR. Refresher ___ |
DOT Initial 24 Hr. ___ |
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Confined Space ___ |
Disaster Site Worker 16 Hr ___ |
First Aid & Adult CPR___ |
Respirators ___ |
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Excavation Safety ___ |
OSHA 10 Hr for Construction ___ |
Quantitative Fit Test ___ Cost Plus Respirator Porting___ |
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Excavation Safety ___ |
OSHA 10 Hour for General Industry ___ |
Hazard Communication ___ |
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Incident Command __ |
RCRA Management ___ |
Emergency Response Team ERT Training ___ |
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Fork Lift Training ___ |
AHA First Aid/Adult CPR __ w/ AED Add __ |
OTHER:____________________________ |
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Terms and conditions:
Check course above! SERVICES REQUIRE this SIGNED REGISTRATION FORM faxed
or scanned and sent to us, Valid ID required. Register for
training. First time customers
prepay at time of service. All courses are tentative until
invoiced and payment is received. Cancellation Policy: FAX Cancel
before fourteen (14) business days of class free thereafter no refunds,[
CANCELLATION WITHIN 14 DAYS WE CHARGE FULL PRICE]
at
start no exceptions without our written approval, no refunds in
order to cover our time that was allocated or seats someone else could
have had, no show no refund, books and the original certifications must
be recovered. We reserve the right to cancel. This may be
due to scheduling & to answer our client’s and Emergency Response needs,
if WE CANCEL there is a FULL
REFUND for cancellation. Cancellations and rescheduling fees apply
(Example $50.00 with letter for dated after booking drug test failure &
military activation excluded, Dr. Letter Medical Emergency, Court letter
Jury Duty). We do not refund last minute project cancellations we have
costs too. We can perform at your facility on a cost plus 15% basis.
Pay by Corporate, or Certified Check, Money Order or Credit Card w/
processing fee. Seats guaranteed upon payment.
Late payments ANY course incur interest 15 % Per Month (or maximum
allowable by law) (No Exceptions)
and [VOID ALL DISCOUNTS and for HAZWOPER 40
Hour cost shall be full price $950.00 .
If you don’t have a credit account here, Paying after the first
day of training is late
registration $950.00 for 40-Hour Courses unless discounted and pay $150 for 8 Hour
Refresher. We reserve the right to adjust our prices may change same
interest and terms for all other services.
Client agrees to pay within
Thirty Days (30 Days) past due an interest fee of 5 % Per Mo. or the
highest allowed by the state the lower of the two shall apply, will be
charged thereafter; non-payment subject to costs for recovery. We
reserve the right to Sub-Contract all or a portion of our services.
Contract for payment on demand unless indicated otherwise.
[Client and all related persons
being serviced by the authorized person signing agreeing to service
shall hold harmless, indemnify, and defend Chicago Safety Institute,
David Hendy Company, Super Safety, premises, or any others e.g.
instructors & contractors, property owners for any accidents, personal
Injury, lost time, injuries, property damage and/or to be not liable for
any circumstances.] Credit Card payment may show on any of these mentioned.
If any part of this agreement shall be found not applicable it shall not
restrict the other parts from being applicable all participants shall be
covered by workers compensation or their own insurance or responsibility
for and accident. [Warning
actual work conditions may differ from training we DISCLAIM any written
or spoken information and it may only be applicable at the time of
training it is for educational purposes only].
This is because we do not supervise your employees
or give medical physicals that is the employers responsibility you agree
your employees are physically fit to get this training 29 CFR
1910.120(f). Discounts may be available. Credit Card payment may show on any of these Hendy Company, Super Safety or Chicago Safety Institute. If any part of this agreement shall be found not applicable it shall not restrict the other parts from being applicable all participants shall be covered by workers compensation or their own insurance or responsibility for and accident. Discounts may be available. THE LEADER THE REST WILL FOLLOW! It's what you learn after you know it all that counts! |
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