Outreach Online Training Certification Statement

Outreach Online Training Certification Statement.pdf

Requirements for the Occupational Safety and Health Administration Training Institute Education Centers Program and Occupational Safety and Health Administration Outreach Training Program

Outreach Online Training Certification Statement

OMB: 1218-0262

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 1218-0262 can be found here:

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ATTACHMENT A
SEC. 21. Training and Employee Education
(a) The Secretary of Health and Human Services, after consultation with the Secretary
and with other appropriate Federal departments and agencies, shall conduct, directly or
by grants or contracts --

29 USC
670

(1) education programs to provide an adequate supply of qualified personnel to carry
out the purposes of this Act, and
(2) informational programs on the importance of and proper use of adequate safety and
health equipment.
(b) The Secretary is also authorized to conduct, directly or by grants or contracts, shortterm training of personnel engaged in work related to his responsibilities under this Act.
(c) The Secretary, in consultation with the Secretary of Health and Human
Services, shall -(1) provide for the establishment and supervision of programs for the education and
training of employers and employees in the recognition, avoidance, and prevention of
unsafe or unhealthful working conditions in employments covered by this Act, and

Pub. L.
105-97,
§2 added
(2) consult with and advise employers and employees, and organizations representing
employers and employees as to effective means of preventing occupational injuries and subsection
(d). See
illnesses.
Historical
notes.
(d) (1) The Secretary shall establish and support cooperative agreements with the States
under which employers subject to this Act may consult with State personnel with respect
to -(A) the application of occupational safety and health requirements under this Act or
under State plans approved under section 18; and
(B) voluntary efforts that employers may undertake to establish and maintain safe and
healthful employment and places of employment. Such agreements may provide, as a
condition of receiving funds under such agreements, for contributions by States
towards meeting the costs of such agreements.

(2) Pursuant to such agreements the State shall provide on-site consultation at the
employer's worksite to employers who request such assistance. The State may also
provide other education and training programs for employers and employees in the
State. The State shall ensure that on-site consultations conducted pursuant to such
agreements include provision for the participation by employees.
(3) Activities under this subsection shall be conducted independently of any
enforcement activity. If an employer fails to take immediate action to eliminate
employee exposure to an imminent danger identified in a consultation or fails to correct
a serious hazard so identified within a reasonable time, a report shall be made to the

appropriate enforcement authority for such action as is appropriate.
(4) The Secretary shall, by regulation after notice and opportunity for comment,
establish rules under which an employer -(A) which requests and undergoes an on-site consultative visit provided under this
subsection;
(B) which corrects the hazards that have been identified during the visit within the
time frames established by the State and agrees to request a subsequent consultative
visit if major changes in working conditions or work processes occur which introduce
new hazards in the workplace; and
(C) which is implementing procedures for regularly identifying and preventing hazards
regulated under this Act and maintains appropriate involvement of, and training for,
management and non-management employees in achieving safe and healthful working
conditions, may be exempt from an inspection (except an inspection requested under
section 8(f) or an inspection to determine the cause of a workplace accident which
resulted in the death of one or more employees or hospitalization for three or more
employees) for a period of 1 year from the closing of the consultative visit.
(5) A State shall provide worksite consultations under paragraph (2) at the
request of an employer. Priority in scheduling such consultations shall be
assigned to requests from small businesses which are in higher hazard industries or
have the most hazardous conditions at issue in the request.

OSHA Training Institute Education Center; Notice of Competition and Request for Appli... Page 1 of 16

Attachment B

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Federal Registers

OSHA Training Institute Education Center; Notice of Competition
and Request for Applications - 72:39851-39859
Federal Registers - Table of Contents

•
•
•
•

Publication Date:
Publication Type:
Fed Register #:
Standard Number:

• Title:

07/20/2007
Notice
72:39851-39859
1910; 1960
OSHA Training Institute Education Center; Notice of
Competition and Request for Applications

[Federal Register: July 20, 2007 (Volume 72, Number 139)]
[Notices]
[Page 39851-39859]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr20jy07-88]
----------------------------------------------------------------------DEPARTMENT OF LABOR
Occupational Safety and Health Administration
OSHA Training Institute Education Center; Notice of Competition
and Request for Applications
AGENCY: Occupational Safety and Health Administration (OSHA), Labor.
ACTION: Notice of competition and request for applications for the OSHA
Training Institute Education Center Program.
----------------------------------------------------------------------SUMMARY: The Occupational Safety and Health Administration (OSHA)
conducts short-term technical training in occupational safety and
health topics through the OSHA Training Institute in Arlington Heights,
Illinois. The number of requests for training from private sector
personnel and federal personnel from agencies other than OSHA increased
beyond the capacity of the OSHA Training Institute to meet the demand.
In October 1992, OSHA began the program of using other training and
educational institutions to conduct select OSHA Training Institute
courses for private sector personnel and for federal personnel from
agencies other than OSHA. Additional information regarding the OTI
Education Center Program background, including a complete list of
current organizations and course offerings, can be found on the OSHA
Web site at: http://www.osha.gov/fso/ote/training/edcenters/index.html.
This notice announces the opportunity for interested nonprofit
organizations to submit applications to become an OSHA Training
Institute Education Center. Applications will be rated on a competitive
basis. Complete application instructions are contained in this notice.
This notice also contains information on a proposal conference designed
to provide potential applicants with information about the OSHA
Training Institute Education Center Program.
DATES: Applications (3 copies) must be received by 4:30 p.m. central

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Attachment B
time on Friday, August 24, 2007. The proposal conference date is
Tuesday, August 7, 2007, from 1 p.m. to 3 p.m. central time, at the
OSHA Directorate of Training and Education, 2020 S. Arlington Heights
Rd., Arlington Heights, Illinois 60005-4102.
ADDRESSES: Submit applications (3 copies) to the U.S. Department of
Labor, Occupational Safety and Health Administration, Directorate of
Training and Education, Office of Training and Educational Programs,
2020 S. Arlington Heights Rd., Arlington Heights, Illinois 60005-4102.
FOR FURTHER INFORMATION CONTACT: Neil Elbrecht, Program Analyst, or Jim
Barnes, Director, Office of Training and Educational Programs, OSHA
Directorate of Training and Education, 2020 S. Arlington Heights Rd.,
Arlington Heights, Illinois 60005-4102, telephone (847) 297-4810.
SUPPLEMENTARY INFORMATION:
OSHA Training Institute (OTI)
The OSHA Training Institute in Arlington Heights, Illinois, is the
primary training provider of the Occupational Safety and Health
Administration. It conducts more than 100 short-term courses and
seminars covering OSHA standards, policies, and procedures for persons
responsible for enforcing or directly supporting the Occupational
Safety and Health Act, for private sector employers and employees, and
federal personnel from agencies other than OSHA. The OSHA Training
Institute's primary responsibility is to federal and state compliance
officers and state consultation program staff. Private sector personnel
and federal personnel from agencies other than OSHA receive training
from the OSHA Training Institute on a space available basis.
OTI Education Center Program Origin
By the early 1990s, requests for training from federal and state
compliance officers, state consultation program staff, private sector
personnel, and federal personnel from agencies other than OSHA had
increased beyond the capacity of the OSHA Training Institute to meet
the demand. In addition, resources of the OSHA Training Institute had
not increased at a rate that could keep up with the demand. As the
number of students from federal and state personnel engaged in
enforcement or consultation increased, opportunities for training for
private sector personnel and federal personnel from agencies other than
OSHA remained static or decreased. In order to meet the increased
demand for its courses, the OSHA Training Institute selected nonprofit
organizations to conduct select OSHA Training Institute courses for
private sector personnel and federal personnel from agencies other than
OSHA. Current organizations were selected through regional
competitions.
Current OTI Education Centers
The current OSHA Training Institute Education Centers are: Keene
State College, Manchester, New Hampshire; Rochester Institute of
Technology, Rochester, New York; University of Medicine & Dentistry of
New Jersey, Piscataway, New Jersey/State University of New York,
Buffalo, New York/Universidad Metropolitana, Bayam[oacute]n Puerto
Rico; Building and Construction Trades Department AFL-CIO/Center to
Protect Workers' Rights, Washington, DC/National Labor College, Silver
Spring, Maryland/West Virginia University, Morgantown, West Virginia;
Indiana University of Pennsylvania, Indiana, Pennsylvania; Georgia
Technical Research Institute, Atlanta, Georgia; Eastern Kentucky
University, Richmond, Kentucky; University of South Florida, Tampa,
Florida; Eastern Michigan University, Ypsilanti, Michigan/United Auto
Workers, Detroit, Michigan/University of Cincinnati, Cincinnati, Ohio;
Northern Illinois University, DeKalb, Illinois/Construction Safety
Council, Hillside, Illinois/National Safety Council, Itasca, Illinois;
Ohio Valley Construction Education Foundation, Springboro, Ohio/

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Attachment B
Sinclair Community College, Dayton, Ohio; Texas Engineering Extension
Service, Texas A&M University System, Mesquite, Texas; Metropolitan
Community Colleges, Business & Technology Center, Kansas City,
Missouri; Kirkwood Community College, Kirkwood, Iowa/Saint Louis
University, Saint Louis, Missouri/National Safety Council of Greater
Omaha, Omaha, Nebraska; University of Utah/Salt Lake Community College,
Salt Lake City, Utah; Red Rocks Community College, Lakewood, Colorado;
University of California, San Diego, San Diego, California; Westside
Energy Services, Taft, California; and the University of Washington,
Seattle, Washington.
OTI Education Center Selection Guidelines
OSHA does not have a predetermined number of organizations to be
selected to act as OSHA Training Institute Education Centers. Rather,
the number of organizations selected will be determined according to
the qualifications of the applicants and their ability to serve the
regional populations. Colleges, universities, or other nonprofit
training organizations will be selected based upon their ability to
conduct OSHA courses for private sector personnel and federal personnel
from agencies other than OSHA.
Geographic Distribution
OSHA Training Institute Education Centers are currently in each
OSHA Region. However, OSHA may elect to select more than one OSHA
Training Institute Education Center in some OSHA Regions. The Regions
contain the following states.
1. Region I: Connecticut, Maine, Massachusetts, New Hampshire,
Rhode Island, and Vermont.
2. Region II: New Jersey, New York, Puerto Rico, and Virgin
Islands.
3. Region III: Delaware, District of Columbia, Maryland,
Pennsylvania, Virginia, and West Virginia.
4. Region IV: Alabama, Florida, Georgia, Kentucky, Mississippi,
North
Carolina, South Carolina, and Tennessee.
5. Region V: Illinois, Indiana, Michigan, Minnesota, Ohio, and
Wisconsin.
6. Region VI: Arkansas, Louisiana, New Mexico, Oklahoma, and Texas.
7. Region VII: Iowa, Kansas, Missouri, and Nebraska.
8. Region VIII: Colorado, Montana, North Dakota, South Dakota,
Utah, and Wyoming.
9. Region IX: American Samoa, Arizona, California, Guam, Hawaii,
Nevada, and Trust Territories of the Pacific.
10. Region X: Alaska, Idaho, Oregon, and Washington.
For this notice of competition, special emphasis will be given to
the following major metropolitan locations:
Austin, TX
Baltimore, MD
Birmingham, AL
Charlotte, NC
Cleveland, OH
Columbus, OH
Hartford, CT
Houston, TX
Indianapolis, IN
Jacksonville, FL
Kansas City, MO
Las Vegas, NV
Los Angeles-Long Beach-Santa Ana, CA
Louisville, KY
Memphis, TN
Miami-Fort Lauderdale, FL
Milwaukee, WI
Minneapolis-St. Paul-Bloomington, MN

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Attachment B
Nashville, TN
New Orleans, LA
New York, NY
Northern New Jersey
Oklahoma City, OK
Orlando, FL
Philadelphia, PA
Phoenix-Mesa-Scottsdale, AZ
Pittsburgh, PA
Portland, OR
Providence, RI
Richmond, VA
Riverside-San Bernardino-Ontario, CA
Sacramento, CA
San Antonio, TX
San Francisco-Oakland-Fremont, CA
San Jose-Sunnyvale-Santa Clara, CA
Virginia Beach-Norfolk-Newport News, VA
Wilmington, DE
OTI Courses Required To Be Presented
OSHA Training Institute Education Centers are required to present
the following six courses on an annual basis:
500 Trainer Course in Occupational Safety and Health Standards
for the Construction Industry
501 Trainer Course in Occupational Safety and Health Standards
for General Industry
502 Update for Construction Industry Outreach Trainers
503 Update for General Industry Outreach Trainers
510 Occupational Safety and Health Standards for the
Construction Industry
511 Occupational Safety and Health Standards for General
Industry
In addition, OTI Education Centers are required to present at least
five of the following courses on an annual basis:
521 OSHA Guide to Industrial Hygiene
2015 Hazardous Materials
2045 Machinery and Machine Guarding Standards
2225 Respiratory Protection
2250 Principles of Ergonomics Applied to Work-Related
Musculoskeletal and Nerve Disorders
2264 Permit-Required Confined Space Entry
3010 Excavation, Trenching and Soil Mechanics
3095 Electrical Standards
3110 Fall Arrest Systems
5600 Disaster Site Worker Train-the-Trainer Course
6000 Collateral Duty Course for Other Federal Agencies
In addition, OTI Education Centers will be allowed, but not
required, to present any of the following short courses and seminars:
7000 OSHA Ergonomic Guidelines for Nursing Homes
7005 Public Warehousing and Storage
7100 Introduction to Machinery and Machine Safeguarding
7105 Evacuation and Emergency Planning
7200 Bloodborne Pathogen Exposure Control for Healthcare
Facilities
7205 Health Hazard Awareness
7300 OSHA's Permit-Required Confined Space Standard
7400 Trainer Course in Construction Noise
7405 Fall Hazard Awareness for the Construction Industry
7500 Introduction to Safety and Health Management
7505 Introduction to Accident Investigation

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Attachment B
7510 Introduction to OSHA for Small Business
7845 Recordkeeping Rule Seminar
A brief description of each of the courses is attached.
OSHA may increase or decrease the number of different courses
available to be offered by the OSHA Training Institute Education
Centers.
Selection Criteria
Applicants will be selected based upon their occupational safety
and health training experience, their nonacademic training background,
the availability of classrooms, laboratories, and conference
facilities, access to transportation and lodging at their resident
location, and their capability to provide training throughout their
Region.
Application Eligibility
Any nonprofit public or private college or university is eligible
to apply. Any other nonprofit organization that can demonstrate that
training or education is part of its mission and that more than 50
percent of its staff and dollar resources is devoted to training or
education is also eligible.
Funding Provisions
OSHA provides no funding to the OSHA Training Institute Education
Centers. The OSHA Training Institute Education Centers will be expected
to support their OSHA training through their normal tuition and fee
structures.
Cooperative Agreement Duration
Selected applicants will sign non-financial cooperative agreements
with OSHA effective October 1, 2007 through September 30, 2012. With
satisfactory performance, agreements may be renewed without competition
for an additional five years.
Geographic Criteria
Applicants must have a physical presence in the OSHA Region for
which they are applying. For example, an eligible national organization
based in San Francisco that has a training facility in Chicago would
have a physical presence in Region V. On the other hand, a national
organization based in New York City that rents hotel space to provide
training at multiple sites around the country would be considered to
have a physical presence only in Region II. OSHA Training Institute
Education Centers are expected to provide training throughout their
respective Regions. In addition, applicants must demonstrate the
capability to locate satellite downlink sites for use by federal and
state employees and private sector employers and employees to receive
satellite delivered training from the OSHA Training Institute. At a
minimum, applicants should identify potential satellite downlink sites
in all cities with a federal or state compliance office or state
consultation office as well as other major population centers within
their Region.
Consortia and Partnerships
Applicants may join with one or more other nonprofit organizations
in their Region to apply as a consortium. A training or education
institution may elect to apply for this program in partnership with a
safety and health organization that is not primarily a training
organization. For example, a university could enter into an agreement
with a labor union that provides for the use of university classrooms
and faculty supplemented by union safety and health professionals. All
consortium partners must be physically located in the same OSHA region.

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Attachment B
OTI Education Center Responsibilities
OSHA Training Institute Education Centers are responsible for the
following:
1. Ensure that instructors are qualified in the courses/subjects
they will be teaching.
2. Arrange for course chairpersons to attend OSHA orientation for
each OSHA Training Institute course for which they are the chair.
3. Schedule courses on a year-round basis with each required course
being offered at least once a year.
4. Schedule courses at various locations throughout their
respective Region.
5. Publicize and promote the availability of courses to ensure
attendance and the delivery of the scheduled courses.
6. Conduct at least five courses per month and achieve annual
student training goals and objectives as established by OSHA.
7. Facilitate student registration.
8. Acquire audiovisual materials for use in the courses.
9. Reproduce handouts for students.
10. Conduct courses in accordance with materials and instructions
provided by OSHA.
11. Monitor courses to ensure that OSHA course outlines are being
followed and OSHA learning objectives are being met.
12. Collect course evaluation data from students in accordance with
OSHA procedures and provide that data to OSHA.
13. Maintain student registration and attendance records in
accordance with OSHA guidelines.
14. Issue course completion certificates to students. These
certificates, which certify that a student has completed training in a
particular course, must be approved by OSHA.
15. Provide the OSHA Directorate of Training and Education with
summary reports indicating number of courses delivered, locations of
courses, and number of students.
16. Maintain clearly identifiable records of tuition and fees
collected from OSHA course students.
17. Identify the availability of appropriate accommodations for
students.
18. Administer Outreach Training Program activities. This includes
distribution of student cards to active Outreach Training Program
trainers and providing trainer and student information to the OSHA
Directorate of Training and Education on a regular basis.
Outreach Training Program
The Outreach Training Program is a voluntary program through which
OSHA authorizes trainers to conduct 10- and 30-hour training courses on
occupational safety and health hazards. Persons who successfully
complete either OSHA Training Institute course 500 Trainer
Course in Occupational Safety and Health Standards for the Construction
Industry or 501 Trainer Course in Occupational Safety and
Health Standards for General Industry are authorized to conduct 10- and
30-hour training courses, to submit training documentation to the
appropriate organization, and issue OSHA course completion cards to
their students. Construction outreach trainers must attend 502
Update for Construction Industry Outreach Trainers once every four
years to maintain their active status, while general industry outreach
trainers must attend 503 Update for General Industry Outreach
Trainers once every four years to maintain their active status.
OSHA Training Institute Responsibilities
The OSHA Training Institute is responsible for the following:
1. Provide OSHA Training Institute Education Center course
chairpersons with orientation on how the OSHA Training Institute
teaches the course.
2. Provide course objectives for each OSHA course to be presented

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Attachment B
by the OSHA Training Institute Education Center.
3. Provide answers and technical assistance on questions of OSHA
policy.
4. Monitor the performance of the OSHA Training Institute Education
Center through on-site visits including unannounced attendance at
courses and examination of course reports and attendance records.
5. Evaluate the effectiveness of the OSHA Training Institute
Education Center and provide each organization with an annual
performance appraisal.
Proposal Conference
The proposal conference is intended to provide potential applicants
with information about the OSHA Training Institute, OSHA Training
Institute courses and methods of instruction, and administrative and
program requirements for a OSHA Training Institute Education Center.
The OSHA Directorate of Training and Education will hold one proposal
conference.
The proposal conference is scheduled for Tuesday, August 7, 2007
from 1 p.m. to 3 p.m. central time, at the OSHA Directorate of Training
and Education, 2020 S. Arlington Heights Rd., Arlington Heights,
Illinois 60005-4102.
Applicants interested in attending this conference may contact Neil
Elbrecht, Program Analyst, or Jim Barnes, Director, Office of Training
and Educational Programs, OSHA Directorate of Training and Education,
2020 S. Arlington Heights Rd., Arlington Heights, Illinois 60005-4102,
telephone (847) 297-4810, for information about local accommodations
and transportation. It is not necessary to register for the conference.
Application Requirements
Applicants must address each of the following points in their
application.
1. Identifying Information. Provide the name and address of their
organization. If the mailing address is a post office box, also provide
the street address. Provide the name, title, and telephone number of
the contact person who can answer questions about the application.
2. Authority to Apply. Provide a copy of the resolution by the
Board of Directors, Board of Regents, or other governing body of their
organization approving the submittal of an application to OSHA to
become an OSHA Training Institute Education Center.
3. Nonprofit Status. Include evidence of the nonprofit status of
their organization and of each member organization if they are applying
as a consortium. A letter from the Internal Revenue Service or a
statement included in a recent audit report is preferred. In the
absence of either of these, a copy of the articles of incorporation
showing the nonprofit status will be accepted.
4. Status as a Training Organization. This section applies only to
applicants that are not colleges or universities. Show that training or
education is a principal activity of their organization. Through audit
reports, annual reports, or other documentation, demonstrate
that for the last two years more than 50 percent of the organization's
funds have been used for training and education activities and that
more than 50 percent of its staff resources have also been used for
this purpose.
5. Occupational Safety and Health Training Experience. Describe the
organization's relevant course offerings for the last two years.
Include copies of catalogs and other recruitment materials that provide
descriptive material about the courses. For each course, include the
dates the course was offered and the number of students who completed
the course. Also provide descriptive material including course
descriptions and number of hours that is similar to the information
contained in the appendix to this Notice.
6. OSHA Training Institute Courses. Indicate which of the OSHA
Training Institute courses the organization would offer. The complete
list of available courses is attached.
7. Staff Qualifications. Describe the qualifications of course

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Attachment B
chairpersons and staff teaching occupational safety and health courses.
Indicate the professional qualifications of each, such as Certified
Safety Professional (CSP), Professional Engineer (PE), or Certified
Industrial Hygienist (CIH). Also describe staff knowledge of and
experience with OSHA standards and their application to hazards and
hazard abatement. Include resumes of current staff and position
descriptions and minimum hiring qualifications for all positions,
whether filled or vacant, that may be assigned to conduct OSHA classes.
8. Classroom Facilities. Describe classroom facilities available
for presentation of the courses. Include number of students
accommodated, table arrangements, and availability of audiovisual
equipment. Also describe appropriate laboratory facilities and other
facilities available for hands-on exercises. Indicate provisions for
accessibility for persons with disabilities.
9. Distance Learning. Describe plans for identifying satellite
downlink sites within the Region for receiving OSHA Training Institute
broadcasts. Identify the types of organizations that would be contacted
and the information that would be made available to the OSHA Training
Institute to ensure a successful broadcast.
10. Outreach Training Program. Provide a description of the systems
that would be in place to administer the Outreach Training Program and
to assure its integrity including maintaining records, ensuring that
only authorized trainers receive student cards, reviewing requests for
student cards, and distributing student cards.
11. Tuition. Provide a copy of the organization's tuition and fee
schedule. Explain how tuition or fees will be computed for each course,
referencing the organization's tuition and fee schedule.
12. Recruitment. Explain procedures for marketing the training
programs, promoting the organizations status as an OSHA Training
Institute Education Center within the region, and recruiting students
from the private sector and from federal agencies other than OSHA.
13. Registration. Describe registration procedures including
provisions for cancellation, furnishing enrollees with hotel
information, and tuition or fee collection.
14. Location. Describe the accessibility of the training facility
for students. Include such items as distance from a major airport,
number of airlines serving the airport, transportation from the airport
to hotels, and distance from the interstate system.
15. Accommodations. Provide a representative listing of hotels
available for student accommodation and give sample room rates. Explain
how students will be transported between the hotels and classes.
Describe the food service and restaurants available both in the area in
which the classes will be held and in the area where the hotels are
located.
16. Off-site Courses. Successful applicants are required to conduct
courses at sites other than their own facilities, especially in other
states in their Region. Describe the organization's plan to provide
off-site training within their respective Region including procedures
to assure that classroom facilities and accommodations are adequate.
17. Nondiscrimination. Provide copies of the organization's
nondiscrimination policies covering staff and students. In the absence
of a written policy, explain how the organization will ensure that
staff and students are selected without regard to race, color, national
origin, sex, age, or disability.
Application Submission
Applications (3 copies) must be submitted to the attention of Jim
Barnes, Director, Office of Training and Educational Programs, OSHA
Directorate of Training and Education, 2020 S. Arlington Heights Rd.,
Arlington Heights, Illinois 60005-4102. The submission is to consist of
one original and two copies of the application. Applications should not
be bound or stapled and should only be printed on one side of the page.
Application Dealine
Applications (3 copies) must be received no later than 4:30 p.m.

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Attachment B
central time on Friday, August 24, 2007.
Application Review Process
A panel of OSHA staff will review the application and will consider
each of the factors listed below.
1. Occupational Safety and Health Training Experience. Evidence
that occupational safety and health training or education has been an
ongoing program of the organization. Reviewers will examine the number
of different occupational safety and health courses offered by the
organization, the number of students completing each course, and the
number of times each course was offered.
2. Qualifications of Staff. For personnel teaching occupational
safety and health courses this includes academic training in
occupational safety and health subjects, experience with the
application of OSHA standards to hazards and hazard abatement,
professional certification, practical experience in the field of
occupational safety and health, and experience in training workers or
managers in nonacademic situations.
3. Outreach Training Program. Plans for administering the Outreach
Training Program and ensuring program integrity will be reviewed.
4. Location. A major airport with regular service to all parts of
the Region should be within a reasonable driving time from the training
location and the hotel. Interstate highways should also be within
reasonable distance.
5. Adequacy of Training Facilities. Potential for accommodating
classes of 25 to 40 students on a year-round basis in settings
comparable to those of the OSHA Training Institute will be reviewed.
Items considered will include classroom layout, availability of
audiovisual equipment, reproduction facilities for handouts, and
availability of appropriate laboratory and hands-on facilities.
Accessibility for persons with disabilities will also be considered.
6. Distance Learning. Successful applicants will demonstrate the
capability to identify satellite downlink sites in their Region for use
by federal and state employees and private sector employers and
employees to receive satellite delivered training from the OSHA
Training Institute. At a minimum, applicants should identify potential
satellite downlink sites in all cities with a federal or state
compliance office or state consultation office as well
as other major population centers within the Region.
7. Recruitment for the programs. Successful applicants will
articulate their detailed plans for marketing the training programs,
promoting status as an OSHA Training Institute Education Center within
the region, and recruiting students from the private sector and from
federal agencies other than OSHA.
8. Registration Procedures. How reasonable are the organization's
procedures for registering students including methods of reaching
potential students, ease of registration, provisions for cancellations,
and system for informing students of available accommodations are among
the items that will be reviewed.
9. Accommodations. Preferably, national hotel/motel chains and
restaurants should be reasonably priced and should be within a few
miles of the training facility.
10. Tuition. Conformance of proposed tuition or fees with the
established policies of the applicant and reasonableness of the charges
will be considered.
11. Off-site Courses. Experience and ability of the organization to
conduct courses at sites other than its own facility will be
considered.
12. Nondiscrimination. Adherence of the organization's policies
with federal requirements will be reviewed.
Application Selection Process
The OSHA review panel will make recommendations to the Assistant
Secretary of Labor for Occupational Safety and Health, who will make
the final decisions.

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Attachment B
Notification of Selection
Applicants will be notified by a representative of the Assistant
Secretary of Labor for Occupational Safety and Health, if their
organization is selected as an OSHA Training Institute Education
Center. An organization may not conduct OSHA Training Institute
Education Center activities until it has signed a non-financial
cooperative agreement with OSHA.
Notification of Non-Selection
Applicants will be notified in writing if their organization is not
selected to be an OSHA Training Institute Education Center.
Non-Selection Appeal
There is no appeal procedure for unsuccessful applicants. All
decisions by the Assistant Secretary of Labor for Occupational Safety
and Health are final.
Applicants may request a copy of the documentation of the review of
their application by writing to Jim Barnes, Director, Office of
Training and Educational Programs, OSHA Directorate of Training and
Education, 2020 S. Arlington Heights Rd., Arlington Heights, Illinois
60005-4102.
Authority
Section 21 of the Occupational Safety and Health Act of 1970 (29
U.S.C. 670).
Signed at Washington, DC, this 16th day of July, 2007.
Edwin G. Foulke, Jr.,
Assistant Secretary of Labor for Occupational Safety and Health.
Attachment
500--Trainer Course in OSHA Standards for Construction
This course is designed for personnel in the private sector
interested in teaching the 10- and 30-hour construction safety and
health outreach program to their employees and other interested groups.
Special emphasis is placed on those topics that are required in the 10and 30-hour programs as well as on those that are the most hazardous,
using OSHA standards as a guide. Course participants are briefed on
effective instructional approaches and the effective use of visual aids
and handouts. This course allows the student to become a trainer in the
Outreach Program and to conduct both a 10- and 30-hour construction
safety and health course and to issue cards to participants verifying
course completion. Prerequisites: Course 510 and five years of
construction safety experience.
Note: Students in Course 500 who wish to participate as
authorized trainers in the Outreach Program must successfully pass a
written exam at the end of the course. Outreach trainers are
required to attend Course 502 at least once every four
years to maintain their trainer status.
501--Trainer Course in OSHA Standards for General Industry
This course is designed for personnel in the private sector
interested in teaching the 10- and 30-hour general industry safety and
health outreach program to their employees and other interested groups.
Special emphasis is placed on those topics that are required in the 10and 30-hour programs as well as on those that are the most hazardous,
using OSHA standards as a guide. Course participants are briefed on
effective instructional approaches and the effective use of visual aids
and handouts. This course allows the student to become a trainer in the

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Attachment B
Outreach Program and to conduct both a 10- and 30-hour general industry
safety and health course and to issue cards to participants verifying
course completion. Prerequisites: Course 511 and five years of
general industry safety experience. Note: Students in Course
501 who wish to participate as authorized trainers in the
Outreach Program must successfully pass a written exam at the end of
the course. Outreach trainers are required to attend Course
503 at least once every four years to maintain their trainer
status.
502--Update for Construction Industry Outreach Trainers
This course is designed for personnel in the private sector who
have completed 500 Trainer Course in Occupational Safety and
Health Standards for the Construction Industry and who are active
trainers in the outreach program. It provides an update on such topics
as OSHA construction standards, policies, and regulations.
Prerequisites: Course 500. Note: Outreach trainers are
required to attend this course once every four years to maintain their
trainer status. Students must bring their current trainer's card for
validation.
503--Update for General Industry Outreach Trainers
This course is designed for private sector personnel who have
completed course 501 Trainer Course in Occupational Safety and
Health Standards for General Industry and who are active trainers in
the outreach program. It provides an update on OSHA general industry
standards and OSHA policies. Prerequisites: Course 501.
Note: Outreach trainers are required to attend this course once
every four years to maintain their trainer status. Students must
bring their current trainer's card for validation.
510--Occupational Safety and Health Standards for Construction
This course for private sector personnel covers OSHA policies,
procedures, and standards, as well as construction safety and health
principles. Topics include scope and application of the OSHA
construction standards. Special emphasis is placed on those areas that
are the most hazardous, using OSHA standards as a guide. Upon
successful course completion, the student will receive an OSHA
construction safety and health 30-hour course completion card.
511--Occupational Safety and Health Standards for General
Industry
This course for private sector personnel covers OSHA policies,
procedures, and standards, as well as general industry safety and
health principles. Topics include scope and application of the OSHA
general industry standards. Special emphasis is placed on those areas
that are the most hazardous, using OSHA standards as a guide. Upon
successful course completion, the student will receive an OSHA general
industry safety and health 30-hour course completion card.
521--OSHA Guide to Industrial Hygiene
This course addresses industrial hygiene practices and related OSHA
regulations and procedures. Topics include permissible exposure limits,
OSHA health standards, respiratory protection, engineering controls,
hazard communication, OSHA sampling procedures and strategy, workplace
health program elements and other industrial hygiene topics. The course
features workshops in health hazard recognition, OSHA health standards
and a safety and health program workshop.
2015--Hazardous Materials
This shortened version of 2010 covers OSHA general

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Attachment B
industry standards and integrates materials from other consensus and
proprietary standards that relate to hazardous materials. Included are
flammable and combustible liquids, compressed gases, LP-gases, and
cryogenic liquids. Related processes such as spraying and dipping are
covered, as well as electrical equipment. Prerequisites: 21(d) State
Consultants: Computer-based 1500 Basic Onsite Consultation
program. Other Federal Agency or Department Personnel: Course
2005, 6000, or 6010. Private Sector and
Other Non-Federal Government personnel: Course 2005,
501, 510, or 511. This course is available
to non-compliance personnel only.
2045--Machinery and Machine Guarding Standards
This shortened version of 2040 familiarizes the student
with various types of common machinery and the related safety
standards. Guidance is provided on the hazards associated with various
kinds of machinery and the control of hazardous energy sources
(lockout/tagout). The course presents an approach to machinery
inspection that enables participants to recognize hazards and to
provide options to achieve abatement. These hazards include mechanical
motions and actions created by points of operation and other machinery
processes. Also included is hands-on training in the laboratories.
Prerequisites: 21(d) State Consultants: Computer-based 1500
Basic Onsite Consultation program. Other Federal Agency or Department
Personnel: Course 2005, 6000, or 6010.
Private Sector and Other Non-Federal Government personnel: Course
2005, 501, 510 or 511. This course
is available to non-compliance personnel only.
2225--Respiratory Protection
This course covers the requirements for the establishment,
maintenance, and monitoring of a respirator program. Topics include
terminology, OSHA standards, National Institute for Occupational Safety
and Health (NIOSH) certification, and medical evaluation
recommendations. Program highlights include laboratories on respirator
selection, qualitative fit testing, and the use of a large array of
respiratory and support equipment for hands-on training.
2250--Ergonomics Applied to MSDs and Nerve Disorders
This course covers the use of ergonomic principles to recognize,
evaluate, and control work place conditions that cause or contribute to
musculoskeletal and nerve disorders. Topics include work physiology,
anthropometry, musculoskeletal disorders, use of video display
terminals, and risk factors such as vibration, temperature, material
handling, repetition, and lifting and transfers in health care. Course
emphasis is on industrial case studies covering analysis and design of
workstations and equipment, laboratory sessions in manual lifting, and
coverage of current OSHA compliance policies. Prerequisites: OSHA
Federal and State Compliance Officers: Course 1000. 21(d)
State Consultants: Computer-based program, ``Basic Onsite
Consultation.'' Safety personnel: Course 1210. Other Federal
Agency or Department personnel: Course 6000, 6010 OR
EQUIVALENT. Private Sector and Other Non-Federal Government personnel:
Course 501, 510, OR EQUIVALENT.
2264--Permit-Required Confined Space Entry
This course is designed to enable students to recognize, evaluate,
prevent, and abate safety and health hazards associated with confined
space entry. Technical topics include the recognition of confined space
hazards, basic information about instrumentation used to evaluate
atmospheric hazards, and ventilation techniques. This course features
workshops on permit entry classification and program evaluation.

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Attachment B
3010--Excavation, Trenching and Soil Mechanics
This course focuses on OSHA standards and on the safety aspects of
excavation and trenching. Students are introduced to practical soil
mechanics and its relationship to the stability of shored and unshored
slopes and walls of excavations. Various types of shoring (wood timbers
and hydraulic) are covered. Testing methods are demonstrated and a oneday field exercise is conducted, allowing students to use instruments
such as penetrometers, torvane shears, and engineering rods.
Prerequisites: All participants must have completed Course
2000, 510, or have equivalent construction training
or experience. Industrial hygienists may substitute Course
1010 for 2000.
3095--Electrical Standards
This shortened version of 3090 is designed to provide the
student with a survey of OSHA's electrical standards and the hazards
associated with electrical installations and equipment. Topics include
single- and three-phase systems, cord- and plug-connected and fixed
equipment, grounding, ground fault circuit interrupters, and safetyrelated work practices. Emphasis is placed on electrical hazard
recognition and OSHA policies and procedures. Students will receive
instruction on safe and correct use of their electrical testing
equipment. Prerequisites: All OSHA personnel must have completed Course
2030 or have equivalent training or experience. Other Federal
Agency or Department personnel: Course 2005, 6000, or
6010 or equivalent. This course is available to noncompliance
personnel only.
3110--Fall Arrest Systems
This course provides an overview of state-of-the-art technology for
fall protection and current OSHA requirements. Topics covered include
the principles of fall protection, the components of fall arrest
systems, the limitations of fall arrest equipment, and OSHA policies
regarding fall protection. Course features a one-day field exercise
demonstrating fall protection equipment. Prerequisites: All
participants must have completed Course 2000, 510, or
have equivalent construction training or experience. Industrial
hygienists may substitute Course 1010 for 2000.
5600--Disaster Site Worker Train-the-Trainer Course
The Disaster Site Worker Train-the-Trainer Course prepares
experienced trainers to present OSHA's 16-hour
Disaster Site Worker Course. Trainers for this course need to be able
to apply the elements of successful adult training programs, along with
specific knowledge, skills, and attitudes to awareness training about
safety and health standards at natural and man-made disaster sites.
Trainers are given the opportunity to practice knowledge, skills, and
attitudes through discussion, planned exercises, demonstrations, and
presentations. Participants receive lesson plans and training materials
for the Disaster Site Worker Course as well as information on training
techniques and resources. Trainers will be expected to present a
selected portion of the Disaster Site Worker Course and to use a
``presentation evaluation'' sheet to evaluate to other presenters.
Prerequisite: The intended audience for this course is authorized OSHA
500 trainers who have also completed the 40-hour HAZWOPER
training.
6000--Collateral Duty Course for Other Federal Agencies
This course introduces federal agency collateral duty safety and
health personnel to the OSH Act, Executive Order 12196, 29 CFR part
1960 and 29 CFR part 1910. The training enables participants to
recognize basic safety and health hazards in the workplace and

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Attachment B
effectively assist agency safety and health officers with inspection
and abatement efforts.
7000--OSHA's Ergonomics Guidelines Training for Nursing Homes
The focus of this one-day course is to use OSHA's Ergonomics
Guidelines for Nursing Homes to develop a process to protect workers in
nursing homes. The course will focus on analyzing and identifying
ergonomic problem jobs and practical solutions to address these
problems. Featured topics include: Developing an ergonomic process;
risk factors in the nursing home guidelines: Identifying problem jobs
including protocol for resident assessment; and implementing solutions
including work practices and engineering solutions.
7005--Public Warehousing and Storage
The course is designed as a training course for warehouse workers
and will focus on many hazards and injuries that are likely to be
encountered in warehouse operations. It has been shown that warehousing
has become an increasingly hazardous area to work in. OSHA has
identified Public Storage and Warehousing as one of seven industries
with a high lost time claims rate. Injuries may occur from forklifts;
material handling and lifting; exposure to hazardous substances; and
slips, trips and falls. The course will discuss: Powered industrial
trucks; material handling/lifting/ergonomics; hazard communication;
walking and working surfaces; and exit routes and fire protection.
7100--Introduction to Machinery and Machine Safeguarding
The main focus of this course is to increase the participant's
knowledge and skill in proper machine safeguarding techniques, and to
highlight the benefits of guarding various types of machinery. It is
the employer's responsibility to identify and select the safeguard
necessary to protect employees and others in the work area, as well as
provide appropriate training in safe work practices. Knowing when and
how to properly safeguard machinery can reduce or eliminate the
potential for accidents and injuries.
7105--Evacuation and Emergency Planning
Evacuation and emergency planning focuses on OSHA requirements for
emergency action plans and fire protection plans. Preparing for
emergencies is a basic principle of workplace safety and health.
Participants will learn: (1) Reasons for emergency action plans and
fire prevention plans and when they are required for a workplace; (2)
elements of a good evacuation plan; and (3) features of design and
maintenance of good exit routes. The optional session for this course
will focus on assessment of risk for terrorist attack and how to
utilize OSHA's two matrices, evacuation planning and fire and
explosion, as tools in planning for emergencies.
7200--Bloodborne Pathogens Exposure Control for Healthcare
Facilities
The purpose of this course is to develop a Bloodborne Pathogens
Exposure Plan for healthcare facilities using a step-by-step approach.
Featured topics include an Introduction to Bloodborne Pathogens
Standard, the Exposure Control Plan, Exposure Determination, Methods of
Control, Vaccinations and Evaluations, Training and Information, and
Record Keeping.
7205--Health Hazard Awareness
This course provides an introduction to common health hazards that
are encountered in the workplace. These health hazards will include
exposure to chemicals, asbestos, silica, and lead. The course will
feature these topics: Identification of hazard; sources of exposure;
health hazard information; evaluation of exposure; and engineering and

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Attachment B
work practice controls. The course materials will include an instructor
and student manual; workshops and group activities; and PowerPoint
presentations. The course is designed as an awareness course for
employers and employees.
7300--OSHA's Permit-Required Confined Space Standard
This one-day course discusses the requirements of OSHA's permitrequired confined space standard, 29 CFR 1910.146. It is designed for
small employers or a designated representative (line supervisor or
manager) with the responsibility to develop a permit space program. It
covers OSHA's requirements but does not feature hands-on sections
(instrumentation and control methods and testing) which are included in
OSHA course 2260.
7400--Trainer Course in Construction Noise
The primary objectives of this one-day course are to increase the
participant's knowledge and skill in construction noise and provide
them with materials and guidance for training their workers. OSHA
published an Advanced Notice for Proposed Rulemaking, Hearing
Conservation Program for Construction Workers. This course builds on
OSHA's efforts to reduce occupational hearing loss in the construction
industry.
7405--Fall Hazard Awareness for the Construction Industry
The focus of this 5-hour course is to identify, evaluate, and
prevent or control fall hazards at constructions sites. The course
focuses on falls to a lower level not falls to the same level resulting
from slips and falls. The target audience is the small construction
employer, business owner, or manager who would like to obtain
information about fall hazards found in the workplace. The training is
also suitable for employees and employee representatives. Topics
include identifying fall hazards, analyzing fall hazards, and
preventing fall hazards as well as OSHA resources addressing fall
hazards.
7500--Introduction to Safety and Health Management
Using interactive assignments and thought-provoking group projects,
students of this one day workshop come away with a strong understanding
of the benefits in implementing a safety and health management system
in the workplace.
7505--Introduction to Accident Investigation
Introduction to accident investigation provides an introduction to
basic accident investigation procedures and describes accident analysis
techniques. The goal of the course is to help participants gain the
basic skills necessary to conduct an effective accident investigation
at their workplace. The target audience is the small employer, manager,
employee or employee representative who, as part of a firm's safety and
health system, would be involved in conducting accident and/or nearmiss investigations.
7510--Introduction to OSHA for Small Business
This course provides an introduction to OSHA for owners and
managers of small businesses. The goal of the course is to help
participants gain an understanding of OSHA operations and procedures
and learn how they can work with OSHA to prevent or reduce injuries and
illnesses in their workplaces. Included in the course is information on
the background of OSHA, standards, the inspection process, implementing
a safety and health program, and assistance available to small
business. It is anticipated that the course materials could be covered
in 3\1/2\ to 4 hours.

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Attachment B
7845--Recordkeeping Rule Seminar
This course is designed to assist employers in identifying and
fulfilling their responsibilities for posting certain records,
maintaining records of illnesses and injuries and reporting specific
cases to OSHA. Participants who successfully complete this course will
be able to identify OSHA requirements and complete new OSHA's forms
300, 300A and 301.
[FR Doc. E7-14049 Filed 7-19-07; 8:45 am]
BILLING CODE 4510-26-P
Federal Registers - Table of Contents

www.osha.gov

www.dol.gov

Contact Us | Freedom of Information Act | Customer Survey
Privacy and Security Statement | Disclaimers
Occupational Safety & Health Administrations
200 Constitution Avenue, NW
Washington, DC 20210

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Attachment C

OSHA Training Institute Education Center Monthly Summary Report

Course Number / Title

Education Center Name

Training Location City

Training
Location
State

(Foreign)
Country

Start Date

End Date

Total
Contact
Students
Hours
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

Course
Chairperson

Attachment C

OSHA Training Institute Education Center Monthly Summary Report

Instructional
Staff

Federal
OSHA
Personnel

Other Federal
Agency
Personnel

State
Other
OSHA
State
Personnel Personnel

Private
Sector
Personnel

U.S.
Students

Foreign
Students

Summary Comments

Attachment C

OSHA Outreach Training Program Monthly Summary Report

Reporting
Month

10-Hour
Construction
Courses

30-Hour
Construction
Courses

10-Hour
General
Industry
Courses

30-Hour
General
Industry
Courses

#7600
Courses

#7615
Courses

#7617
Courses

#7618
Courses

#7635
Courses

#7637
Courses

#7638
Courses

10-Hour
30-Hour
Constructi Constructi
on
on
Students
Students

Total
Courses

October

November

December

January

February

March

April

May

June

July

August

September
Totals

10-Hour
General
Industry
Students

30-Hour
General
Industry
Students

#7600
Students

0
0

Attachment C

OSHA Outreach Training Program Monthly Summary Report

Reporting
Month

#7615
Students

#7617
Students

#7618
Students

#7635
Students

#7637
Students

#7638
Students

Total
Students

Comments

October

November

December

January

February

March

April

May

June

July

August

September
Totals

0
0

Attachment D

Statement of Compliance with Outreach Training Program Requirements
I certify that I will conduct all outreach training classes in accordance with the
OSHA Outreach Training Program guidelines. I understand that it is my
responsibility to ensure that I meet the requirements of the most recent edition of the
OSHA Outreach Training Program guidelines. I will maintain the training records
as required by these guidelines and I will provide these records to the OSHA
Directorate of Training and Education (or its designee) upon request. I understand
that I will be subject to immediate dismissal from the Outreach Training Program if I
provide information that is not true and correct. I further understand that providing
false information may subject me to civil and criminal penalties under Federal law,
including 18 U.S.C. Sec. 1001, and/or section 17(g) of the Occupational Safety and
Health Act, 19 U.S.C. 666(g), which provides criminal penalties for making false
statements or representations.

_________________________________
Trainer Signature

________________________________
Date

__________________________________
Typed or Printed Name

______________________________________________
Name of Course & Course Dates (To be completed by OTI Education Center)

_____________________________________________
Name of OTI Education Center (To be completed by OTI Education Center)

U.S. DEPARTMENT OF LABOR
OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION

FORM APPROVED
OMB NO. ####-####
[Form Expiration Date]

OUTREACH TRAINING PROGRAM REPORT
CONSTRUCTION
Read instructions before completing this form.

Submit completed forms to:

1. Trainer Name

2. ID No.

3. Recent Trainer Course

4. Expiration Date
/
/

5. Authorizing Training Organization
6. Trainer Address

Check if this is a new address

Company
Address

City

Phone No.
(
Course Conducted
10-hour
30-hour

State

ZIP

)
Email
8. Course Information (check all that apply)
Spanish
Language other than English or Spanish (specify):
Youth (age 18 or less)
OSHA Alliance or Partnership (specify):

9. No. of
Students

10. Training Site Address
Street address
11. Type of Training Site
Workplace
School
12. Course Duration
Start Date
13. Sponsoring Organization
Safety & Health
Education

City
Office
End Date
Employer
Community

Hotel

Union

State
Employer Association

Other (specify):

Start Time
Labor/Union
N/A

Country

End Time
Employer Association
Other (specify)

14. Statement of Certification

I certify that I have conducted this outreach training class in accordance with the OSHA Outreach Training Program guidelines. I have
maintained the training records as required by these guidelines and I will provide these records to the OSHA Directorate of Training and
Education (or their designee) upon request. I understand that I will be subject to immediate dismissal from the OSHA Outreach Training
Program if information provided herein is not true and correct. I further understand that providing false information herein may subject me
to civil and criminal penalties under Federal law, including 18 U.S.C. 1001 and section 17(g) of the Occupational Safety and Health Act,
29 U.S.C.666(g), which provides criminal penalties for making false statements or representations in any document filed pursuant to that
Act. I hereby attest that all provided is true and correct.
Trainer Signature:

Date:

If submitting this form by electronic means, by checking the box to the left or affixing signature, I attest that all information provided in
this submission is true and accurate.
Privacy Act Statement and Paperwork Reduction Act Statement
The Privacy Act of 1974 as amended (5 U.S.C. 552a), section 901 of Title 30 to the US Code and 20 CFR 725.504 - 513 authorize collection of this information. The purpose of this information is to
determine whether the trainer is authorized and whether the training was properly completed. Completion of this form is not mandatory, however, this information is required to obtain OSHA
student course completion cards. Additional disclosures of this information are not required.
According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. Public reporting
burden for this collection of information is estimated to average 15 minutes per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the
data needed, and completing and reviewing the collection of information. The obligation to respond to this collection is required to obtain OSHA student course completion cards as stated in
OSHA’s Outreach Training Program guidelines. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden,
to the U.S. Department of Labor, Occupational Safety and Health Administration, Directorate of Standards and Guidance, 200 Constitution Avenue, NW, Room N3718, Washington, DC 20210 and
reference the OMB Control Number. Note: Please do not return the completed OSHA Form XXXX to this address.

Attachment E

OSHA Form ###
Month 2009

U.S. DEPARTMENT OF LABOR
OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION

FORM APPROVED
OMB NO. ####-####
[Form Expiration Date]

OUTREACH TRAINING PROGRAM REPORT
CONSTRUCTION
Read instructions before completing this form.

16. Student Names
Note: ensure that names are legible
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
34.
35.
36.
37.
38.
39.
40.
41.
42.
43.
44.
45.
46.
47.
48.
49.
50.

15. Topic Outline
10-Hour Topics
*Indicate the amount of time spent on each of the topics in the class.
REQUIRED
Hours *
Introduction to OSHA
OSHA Focus Four Hazards—note the total time spent on the line
to the left, and indicate the time breakdown on each line below:
Fall Protection
Electrical
Struck By
Caught in/between
Personal Protective and Lifesaving Equipment
Health Hazards in Construction—e.g. noise, hazard
communication and silica
ELECTIVE
Materials Handling, Storage, Use and Disposal
Tools - hand and power
Scaffolds
Cranes, Derricks, Hoists, Elevators, and Conveyors
Excavations
Stairways and Ladders
OPTIONAL

TOTAL
.

30-Hour Topics
*Indicate the amount of time spent on each of the topics in the class.
REQUIRED
Hours *
Introduction to OSHA
OSHA Focus Four Hazards— note the total time spent on the line
to the left, and indicate the time breakdown on each line below:
Fall Protection
Electrical
Struck By
Caught in/between
Personal Protective and Lifesaving Equipment
Health Hazards in Construction—e.g. noise, hazard
communication and silica
Stairways and Ladders
ELECTIVE
Fire Protection and Prevention
Materials Handling, Storage, Use and Disposal
Tools – Hand and Power
Welding and Cutting
Scaffolds
Cranes, Derricks, Hoists, Elevators, and Conveyors
Motor Vehicles, Mechanized Equipment and Marine
Operations; Rollover Protective Structures and Overhead
Protection; and Signs, Signals and Barricades
Excavations
Concrete and Masonry Construction
Steel Erection
Safety and Health Program
Confined Space Entry
Powered Industrial Vehicles
Ergonomics
OPTIONAL

TOTAL

Attachment E

Page 2

OSHA Form ###
Month 2009

U.S. DEPARTMENT OF LABOR
OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION

FORM APPROVED
OMB NO. ####-####
[Form Expiration Date]

OUTREACH TRAINING PROGRAM REPORT
Instructions for Outreach Trainer
The Outreach Training Program is the Occupational Safety and Health Administration’s (OSHA) voluntary orientation training
program aimed at workers. It provides workers with information about OSHA and provides an overview of job hazards.
Trainers authorized through the OSHA Outreach Training Program must conduct outreach training classes in accordance with
the current Outreach Training Program Guidelines issued by the Directorate of Training and Education (DTE). The Outreach
Training Program Guidelines can be found online at the OSHA.gov website under Training, OSHA Outreach Training Program.
Item 9

No. of Students
Indicate the number of students who completed
the course. Note: If you held a class of more
than 50 students, include a copy of the prior
approval received from OSHA or the OTI
Education Center.

Item 10

Training Site Address
Provide the address, city, state, and country
where the course was conducted.

Item 11

Type of Training Site
Place an “x” next to the type of site where the
training was held. If none of the choices apply,
specify the type of training site.

Item 12

Expiration Date
Enter your trainer expiration date as listed on the
bottom right of your Authorized Outreach
Trainer card.

Course Duration
Enter the start date, end date, start time, and end
time of the course.

Item 13

Authorizing Training Organization
List the name of the OSHA Training Institute
(OTI) Education Center responsible for your last
trainer or update course, or indicate if your
training was completed at the OSHA Training
Institute. See Attachment B of the Outreach
Training Program guidelines for this information
and options for where to send your card request.

Sponsoring Organization
Place an “x” in the box to indicate the sponsor of
the training, if applicable. If you had a sponsor,
but that type of organization is not a choice,
check “Other” and specify the type of
sponsoring group or organization.

Item 14

Statement of Certification
The authorized trainer must sign the statement
of certification to verify that the class was
conducted in accordance with OSHA’s
guidelines and attest to the accuracy of the
documentation submitted. If requesting cards
electronically, the trainer must place an “x” in
the box or affix a signature.

Item 15

Topic Outline
Complete the applicable 10- or 30-hour topic
outline. You must complete this part of the
form.

Item 16

Student Names
List the first and last name of each student who
completed the entire course. If mailing or faxing
this form, ensure the names are legible. Your
course records must include sign-in sheets for
each day and indicate the card number
dispensed to each student.

Item 1

Trainer Name
List your full name. When completing student
course completion cards, print or type your
name on each card to ensure it is legible.

Item 2

ID No.
This applies only to trainers who have already
received student cards. New trainers do not
have an ID number. ID numbers are issued to
trainers after their initial course is documented.
If this is your first class, or if you have updated
your trainer status, include a copy of your
trainer card.

Item 3

Item 4

Item 5

Item 6

Item 7

Item 8

Recent Trainer Course
Indicate the most recent applicable course
number you have completed.

Trainer Address
Provide an address where to send the cards. The
address you provide should ensure that the
cards are sent directly. If you have an ID
number and there are no address changes, you
are not required to fill in this section.
Course Conducted
Place an “x” in the appropriate box. A separate
report must be completed for each course
completed.
Course Information (check all that apply)
Place an “x” next to all the information that
applies to the majority of this course.

Attachment E

Page 3

OSHA Form ###
Month 2009

U.S. DEPARTMENT OF LABOR
OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION

FORM APPROVED
OMB NO. ####-####
[Form Expiration Date]

OUTREACH TRAINING PROGRAM REPORT
GENERAL INDUSTRY
Read instructions before completing this form.

Submit completed forms to:

Trainer Name

2. ID No.

Authorizing Training Organization

Trainer Address

3. Recent Trainer Course

4. Expiration Date
/
/

Check if this is a new address

Company
Address

City

Phone No.
(
Course Conducted
10-hour
30-hour

State

ZIP

)
Email
8. Course Information (check all that apply)
Spanish
Language other than English or Spanish (specify):
Youth (age 18 or less)
OSHA Alliance or Partnership (specify):

10. Training Site Address
Street address
11. Type of Training Site
Workplace
School

City
Office

Hotel

Union

State
Employer Association

9. No. of
Students

Country

Other (specify):

12. Course Duration
Start Date
13. Sponsoring Organization
Safety & Health
Education

End Date
Employer
Community

Start Time
Labor/Union
N/A

End Time

Employer Association
Other (specify)

14. Statement of Certification

Date:

Attachment F

OSHA Form ###
Month 2009

U.S. DEPARTMENT OF LABOR
OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION

FORM APPROVED
OMB NO. ####-####
[Form Expiration Date]

OUTREACH TRAINING PROGRAM REPORT
GENERAL INDUSTRY
16. Student Names
(ensure that names are legible)

15. Topic Outline
10-Hour Topics
*Indicate the amount of time spent on each of the topics in the class.
REQUIRED
Hours *
Introduction to OSHA
Walking and Working Surfaces
Electrical
Hazard Communication
Exit Routes, Emergency Action Plans, Fire Prevention Plans,
and Fire Protection
Personal Protective Equipment

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
34.
35.
36.
37.
38.
39.
40.
41.
42.
43.
44.
45.
46.
47.
48.
49.
50.

ELECTIVE
Hours *
Hazardous Materials (Flammable and Combustible Liquids)
Materials Handling
Machine Guarding
Introduction to Industrial Hygiene
Bloodborne Pathogens
Ergonomics
Safety and Health Programs
Fall Protection
OPTIONAL
Hours *

TOTAL

30-Hour Topics
*Indicate the amount of time spent on each of the topics in the class.
REQUIRED
Hours *
Introduction to OSHA
Walking and Working Surfaces
Electrical
Exit Routes, Emergency Action Plans, Fire Prevention Plans,
and Fire Protection
Personal Protective Equipment
Materials Handling
Hazard Communication
ELECTIVE
Hours *
Hazardous Materials (Flammable and Combustible Liquids)
Permit-Required Confined Spaces
Lockout / Tagout
Machine Guarding
Welding, Cutting and Brazing
Introduction to Industrial Hygiene
Bloodborne Pathogens
Ergonomics
Fall Protection
Safety and Health Programs
Powered Industrial Vehicles
OPTIONAL
Hours *

TOTAL

Attachment F

Page 2

OSHA Form ###
Month 2009

U.S. DEPARTMENT OF LABOR
OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION

FORM APPROVED
OMB NO. ####-####
[Form Expiration Date]

Item 10

Training Site Address
Provide the address, city, state, and country
where the course was conducted.

Item 11

Type of Training Site
Place an “x” next to the type of site where the
training was held. If none of the choices apply,
specify the type of training site.

Item 12

Expiration Date
Enter your trainer expiration date as listed on the
bottom right of your Authorized Outreach
Trainer card.

Course Duration
Enter the start date, end date, start time, and end
time of the course.

Item 13

Item 14

Item 15

Topic Outline
Complete the applicable 10- or 30-hour topic
outline. You must complete this part of the
form.

Item 16

Item 1

Trainer Name
List your full name. When completing student
course completion cards, print or type your
name on each card to ensure it is legible.

Item 2

Item 3

Item 4

Item 5

Item 6

Item 7

Item 8

Recent Trainer Course
Indicate the most recent applicable course
number you have completed.

Attachment F

Page 3

OSHA Form ###
Month 2009

U.S. DEPARTMENT OF LABOR
OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION

FORM APPROVED
OMB NO. ####-####
[Form Expiration Date]

OUTREACH TRAINING PROGRAM REPORT
MARITIME
Read instructions before completing this form.

Submit completed forms to:

Trainer Name

2. ID No.

Authorizing Training Organization

Trainer Address

3. Recent Trainer Course

4. Expiration Date
/
/

Check if this is a new address

Company
Address

City

State

Phone No.
(
)
Course Conducted
10-hour #7615-Shipyards
10-hour #7617-Marine Terminals
10-hour #7618-Longshoring
30-hour #7635-Shipyards
30-hour #7637-Marine Terminals
30-hour #7638-Longshoring
10. Training Site Address
7.

Street address
11. Type of Training Site
Workplace
School

Email
8. Course Information (check all that apply)
Spanish
Language other than English or Spanish (specify):
Youth (age 18 or less)

City
Office

ZIP

Hotel

Union

9. No. of
Students

OSHA Alliance or Partnership (specify):

State
Employer Association

Country
Other (specify):

12. Course Duration
Start Date
End Date
13. Sponsoring Organization
Safety & Health
Employer
Education
Community

Start Time
Labor/Union
N/A

End Time
Employer Association
Other (specify)

14. Statement of Certification
I certify that I have conducted this outreach training class in accordance with the OSHA Outreach Training Program guidelines. I have maintained the
training records as required by these guidelines and I will provide these records to the OSHA Directorate of Training and Education (or their designee)
upon request. I understand that I will be subject to immediate dismissal from the OSHA Outreach Training Program if information provided herein is not
true and correct. I further understand that providing false information herein may subject me to civil and criminal penalties under Federal law, including
18 U.S.C. 1001 and section 17(g) of the Occupational Safety and Health Act, 29 U.S.C.666(g), which provides criminal penalties for making false
statements or representations in any document filed pursuant to that Act. I hereby attest that all provided is true and correct.

Trainer Signature:
Date:
If submitting this form by electronic means, by checking the box to the left or affixing signature, I attest that all information provided in
this submission is true and accurate.
Privacy Act Statement and Paperwork Reduction Act Statement
The Privacy Act of 1974 as amended (5 U.S.C. 552a), section 901 of Title 30 to the US Code and 20 CFR 725.504 - 513 authorize collection of this information. The purpose of this information is to
determine whether the trainer is authorized and whether the training was properly completed. Completion of this form is not mandatory, however, this information is required to obtain OSHA
student course completion cards. Additional disclosures of this information are not required.
According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. Public reporting
burden for this collection of information is estimated to average 20 minutes per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the
data needed, and completing and reviewing the collection of information. The obligation to respond to this collection is required to obtain OSHA student course completion cards as stated in
OSHA’s Outreach Training Program guidelines. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden,
to the U.S. Department of Labor, Occupational Safety and Health Administration, Directorate of Standards and Guidance, 200 Constitution Avenue, NW, Room N3718, Washington, DC 20210 and
reference the OMB Control Number. Note: Please do not return the completed OSHA Form XXXX to this address.

Attachment G

OSHA Form ###
Month 2009

U.S. DEPARTMENT OF LABOR
OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION

FORM APPROVED
OMB NO. ####-####
[Form Expiration Date]

OUTREACH TRAINING PROGRAM REPORT
MARITIME
15. Topic Outline
*Indicate the amount of time spent on each of the topics in the class.
REQUIRED

Hours *
Introduction to OSHA (#7615, #7617, #7618)
Walking & Working Surfaces (#7615, #7617, #7618)
Personal Protective Equipment (#7615, #7617,
#7618)
Fall Protection / Scaffolding (#7615)
Electrical (#7615)
Confined and Enclosed Spaces (#7615)
Fire Protection (#7615)
ELECTIVE
Hours *

Hazard Communications / Hazardous Materials
Lockout / Tagout
Respiratory Protection
Fall Protection (#7617, #7618)
Electrical (#7617, #7618)
Confined and Enclosed Spaces (#7617, #7618)
Fire Protection (#7617, #7618)
OPTIONAL

Hours *
Hot Work – Welding, Burning & Cutting
Material Handling
Bloodborne Pathogens
Machine Guarding
Ergonomics and Proper Lifting Techniques
OTHER
Hours *

TOTAL

Attachment G

16. Student Names
(ensure that names are legible)
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
34.
35.
36.
37.
38.
39.
40.
41.
42.
43.
44.
45.
46.
47.
48.
49.
50.

Page 2

OSHA Form ###
Month 2009

U.S. DEPARTMENT OF LABOR
OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION

FORM APPROVED
OMB NO. ####-####
[Form Expiration Date]

Trainer Name
List your full name. When completing student
course completion cards, print or type your
name on each card to ensure it is legible.

Item 2

Item 3

Item 4

Item 5

Item 6

Item 7

Item 8

Item 9

Item 10

Training Site Address
Provide the address, city, state, and country
where the course was conducted.

Item 11

Type of Training Site
Place an “x” next to the type of site where the
training was held. If none of the choices apply,
specify the type of training site.

Item 12

Expiration Date
Enter your trainer expiration date as listed on the
bottom right of your Authorized Outreach
Trainer card.

Course Duration
Enter the start date, end date, start time, and end
time of the course.

Item 13

Item 14

Item 15

Topic Outline
Complete the applicable 10- or 30-hour topic
outline. You must complete this part of the
form.

Item 16

Recent Trainer Course
Indicate the most recent applicable course
number you have completed.

Attachment G

Page 3

OSHA Form ###
Month 2009

U.S. DEPARTMENT OF LABOR
OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION

FORM APPROVED
OMB NO. ####-####
[Form Expiration Date]

OUTREACH TRAINING PROGRAM REPORT
DISASTER SITE WORKER
Read instructions before completing this form.

Submit completed forms to:

Trainer Name

2. ID No.

Authorizing Training Organization

Trainer Address

3. Recent Trainer Course

4. Expiration Date
/
/

Check if this is a new address

Company
Address

City

Phone No.
(
Course Conducted
16-hour

State

ZIP

)
Email
8. Course Information (check all that apply)
Spanish
Language other than English or Spanish (specify):
Youth (age 18 or less)
OSHA Alliance or Partnership (specify):

9. No. of
Students

10. Training Site Address
Street address
11. Type of Training Site
Workplace
School

City
Office

Hotel

Union

State
Employer Association

Country
Other (specify):

12. Course Duration
Start Date
End Date
13. Sponsoring Organization
Safety & Health
Employer
Education
Community

Start Time
Labor/Union
N/A

End Time
Employer Association
Other (specify)

14. Statement of Certification

I certify that I have conducted this outreach training class in accordance with the OSHA Outreach Training Program guidelines. I have
maintained the training records as required by these guidelines and I will provide these records to the OSHA Directorate of Training and
Education (or their designee) upon request. I understand that I will be subject to immediate dismissal from the OSHA Outreach Training
Program if information provided herein is not true and correct. I further understand that providing false information herein may subject
me to civil and criminal penalties under Federal law, including 18 U.S.C. 1001 and section 17(g) of the Occupational Safety and Health
Act, 29 U.S.C.666(g), which provides criminal penalties for making false statements or representations in any document filed pursuant to
that Act. I hereby attest that all provided is true and correct.
Trainer Signature:

Date:

Attachment H

OSHA Form ###
Month 2009

U.S. DEPARTMENT OF LABOR
OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION

FORM APPROVED
OMB NO. ####-####
[Form Expiration Date]

OUTREACH TRAINING PROGRAM REPORT
DISASTER SITE WORKER
16. Student Names
(ensure that names are legible)
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
34.
35.
36.
37.
38.
39.
40.
41.
42.
43.
44.
45.
46.
47.
48.
49.
50.

15. Training Certifications and Information
I certify that I taught all the required topics and met the Lesson
Objectives of the Disaster Site Worker Course #7600.
I certify that I conducted the training for a minimum of 16 hours.
I certify that I have maintained supporting documentation on the
respirator performance checklists and scores.
The range of scores that I recorded for the Operations Performance
Score in the respiratory protection performance test:

From

Trainer Signature

Attachment H

Page 2

OSHA Form ###
Month 2009

U.S. DEPARTMENT OF LABOR
OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION

FORM APPROVED
OMB NO. ####-####
[Form Expiration Date]

Item 10

Training Site Address
Provide the address, city, state, and country
where the course was conducted.

Item 11

Type of Training Site
Place an “x” next to the type of site where the
training was held. If none of the choices apply,
specify the type of training site.

Item 12

Expiration Date
Enter your trainer expiration date as listed on the
bottom right of your Authorized Outreach
Trainer card.

Course Duration
Enter the start date, end date, start time, and end
time of the course.

Item 13

Item 14

Item 15

Topic Outline
Complete the applicable 10- or 30-hour topic
outline. You must complete this part of the
form.

Item 16

Item 1

Trainer Name
List your full name. When completing student
course completion cards, print or type your
name on each card to ensure it is legible.

Item 2

Item 3

Item 4

Item 5

Item 6

Item 7

Item 8

Recent Trainer Course
Indicate the most recent applicable course
number you have completed.

Attachment H

Page 3

OSHA Form ###
Month 2009

OSHA OUTREACH TRAINING PROGRAM REPORT
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

-- Online Outreach Training Program Report -----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

10-Hour Construction
10-Hour General Industry

30-Hour Construction
30-Hour General Industry

Statement of Certification. I certify that I have conducted this outreach training class in accordance with the OSHA Outreach Training
Program guidelines. I have maintained the training records as required by these guidelines and I will provide these records to the OSHA
Directorate of Training and Education (or their designee) upon request. I understand that I will be subject to immediate dismissal from the
OSHA Outreach Training Program if information provided herein is not true and correct. I further understand that providing false
information herein may subject me to civil and criminal penalties under Federal law, including 18 U.S.C. 1001 and section 17(g) of the
Occupational Safety and Health Act, 29 U.S.C.666(g), which provides criminal penalties for making false statements or representations in any
document filed pursuant to that Act. I hereby attest that the information on this form is true and correct.

____________________________________________

________________________

Trainer Signature

Date

Trainer: __________________________________
Online Group Affiliation: _____________________________________
ID Number: __________
Total Students: __________
End Date: ____________

Student Name

Attachment I

Training
No. of times took to
Completion Date pass Final

Final Test Score
Percentage

Time Spent
Online

Attachment J

OSHA Region: ______
OTIEC: ____________________________________
City: _________________________ State: _______

Attachment J

OSHA Region: ______
OTIEC: ____________________________________
City: _________________________ State: _______

File Type	application/pdf
File Title	http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=O
Author	knewell
File Modified	2010-03-27
File Created	2009-02-26