DO NOT TRY TO FILL IN THIS MESSAGE IN YOUR WEB BROWSER. This is not one of those kinds of forms.
You must either print out this page, fill it in, and fax it to David Carlson - 906/487-2495, or you can highlight, copy, and paste it into the body of an email message. If you opt for email, paste the form into a new email and then fill in the form by typing over the lines. Then email it to dcarlson@mtu.edu
Contractor Training Needs Survey
Company Name:__________________________________
Company Address:________________________________
Name of Contact Person:____________________________
email address:____________________________________
Number of Employees Needing Training:
Annual Refresher Training - Part 46___, Part 48___, Both___.
New Inexperienced Miner Training ____
New Experienced Miner Training ____
First Aid Training ____
Hazcom training ____
Hearing Conservation Program Training ____
Desired Location (City,Town & possible training facility if known)
_________________________________________________
_________________________________________________
How soon would you like to complete this training? __________
_________________________________________________
Are you working in both Part 46 and 48 mines? Yes___, No___.
Do you have a training plan? Yes____, No____
Would you like us to prepare your training plan? Yes___, No___
Are there other ways we can assist you?___________________
__________________________________________________
__________________________________________________