Advance Safety and Health Certificate

Advanced Safety & Health Certificate Advanced Safety & Health Certificate
Application Form

Requirements

  • To receive the CSUDH Advanced Safety & Health Certificate participants must complete at least three (3) courses through the CSUDH OTI Education Center.
  • The two final Advanced Safety & Health Certificate courses must be taken through the CSUDH OTI Education Center.
  • Courses taken through the Chicago-based OSHA Training Institute or other official OSHA Training Institute Education Centers can be used to fulfill up to four of the courses required for the CSUDH Advanced Safety & Health Certificate if they were completed within two years prior to the participant’s official “certificate enrollment date.
  • All coursework must be completed within three years after the official “certificate enrollment date.” The official “certificate enrollment date” is the first day of the first CSUDH OTI Education Center Certificate class the participant wishes to count towards the Certificate.

Student Information


[Name as it should appear on the printed Certificate]

[Include Street Address, City, State and Zip Code]
Construction Track
General Industry Track

Required Courses (check all that apply)

Construction Track — (4 Required Courses)




— OR —

General Industry Track — (4 Required Courses)





Electives for all Tracks — (3 Elective Courses)



























Student Signature