Certified Safety and Health Official (CSHO) Certificate Request

Certified Safety and Health Official Certificate Certified Safety & Health Official (CSHO) Certificate
Application Form

Requirements

  • To earn the CSHO Certificate, the individual will have to successfully complete eight (8) required courses.
  • At least four (4) of the courses, including the final two, must be completed through the CSUDH OTI Education Center.
  • All courses must be completed within a 5 year period. The official “certificate enrollment date” is the first day of the first CSUDH OTI Education Center course the participant wishes to count towards the certificate of completion.
  • Courses taken through other official OSHA Training Institute Education Centers can be used to fulfill up to four courses required for the CSHO certificate of completion, if they were completed within two years prior to the participant’s official “certificate enrollment date”.

Student Information


[Name as it should appear on the printed Certificate]

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

Certificate Courses (check all that apply)

Courses for Construction Track:

— Required (6 Courses)








— Electives (2 Courses) (choose 2 of the following:)







 


— OR —

 

Courses for General Industry Track:

— Required (6 Courses)








— Electives (2 Courses) (choose 2 of the following:)







Student Signature