Certified Safety and Health Official (CSHO) Certificate Request

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

Requirements for Certificate of Completion

  • 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.

Requirements for Courses from Other OTIECs

  • Courses taken through other official OSHA Training Institute Education Centers can be used to fulfill up to four (4) courses required for the certificate of completion if these courses were completed within two (2) years prior to the participant’s official certificate begin date at CSUDH OTIEC.
  • Proof (certificate/transcript) for any course taken at another center should be emailed to osha@csudh.edu titled "Certificate Request {student name}" when submitting a Certificate Request.

 

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