Competent Person Safety Training Affiliate Host Site Request Form

Host Site Request Form for Competent Person Safety Training

Before completing this form, please review the "Host Affiliate Checklist". Once you've had a chance to review, please submit this form to initiate the scheduling process. Once the administrator has found a trainer for one of your requested dates, you'll receive a confirmation with next steps and an introduction to your trainer.

1. Your Name *This question is required.

2. Your Title *This question is required.

3. Your Email address *This question is required. This question requires a valid email address.

4. Your Phone Number *This question is required.

5. Your Affiliate *This question is required.

7. Shipping Address for Training Materials (NO P.O. Boxes!)
(This is the address where we'll send the training booklets via FedEx)
*This question is required.

8. Training Date Choice 1 - Must be at least 2 weeks from today's date
Your first choice for start date of 2-day training period. (It's best not to begin trainings on Mondays. Please try to confirm these dates are ok with your team first before placing the request)

*This question is required. This question requires a valid date format of MM/DD/YYYY.

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9. Training Date Choice 2 - Must be at least 2 weeks from today's date
Your first choice for start date of 2-day training period. (It's best not to begin trainings on Mondays. Please try to confirm these dates are ok with your team first before placing the request) *This question is required. This question requires a valid date format of MM/DD/YYYY.

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10. Training Date Choice 3 - Must be at least 2 weeks from today's date
Your first choice for start date of 2-day training period. (It's best not to begin trainings on Mondays. Please try to confirm these dates are ok with your team first before placing the request) *This question is required. This question requires a valid date format of MM/DD/YYYY.

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11. Address of Training Location
This is where the training will be held (may or may not be onsite at your affiliate). This address is what will be provided to the trainer for directions, so please make it as accurate as possible.

*This question is required.

12. Day-Of-Event Contact Person
This is the point-person who will act as liaison for our Master Safety Trainer.
*This question is required.

13. Day-Of-Event Contact Person's Title
*This question is required.

14. Day-Of-Event Contact Person's Email

*This question is required. This question requires a valid email address.

15. Day-Of-Event Contact Person's Cell Phone (in case trainer gets lost/locked out of building, etc.) *This question is required.

16. How many people do you plan to have in the class from your affiliate? *This question is required.

17. HFHI's portion of the training cost is $125 per person, however you may select an additional amount below to add on in order to help cover your hosting fees. If you need help estimating, see the tool entitled "Sample budget calculator and event planner" *This question is required.

Please enter an 'other' value for this selection.