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CCSA Training Request Form

Are you interested in registering for CCSA safety training but don’t see anything scheduled?
Please complete this form and a CCSA Consultant will get in touch to work out a plan with you.

    Contact Person Details

    First Name*:

    Last Name*:

    Your Email*:

    Phone*:

    Organization / Facility Name*:

    Are you a CCSA member? (WCB industry codes 82800 and 82808)
    Yes, my organization is a memberNo, my organization is not a member

    Address:*

    Street Address:

    Unit/Apt:

    City:

    Province:

    Postal Code:

    For full course descriptions please visit: Courses

    Which workshop(s) are you interested in? (check all that apply)
    Manual Materials Handling (MMH) - 4hrsSafe Resident Handling (SRH) - 4hrsMMH & SRH Combo - 8hrsWork Site Inspection - 4hrsIncident Investigation - 4hrsHazard Assessment & Control - 4hrsHealth & Safety Committee/Rep -8hrsManaging Workplace Violence & Aggression - 4hrsOther

    Which In-service(s) are you interested in? (check all that apply)
    Root Cause Analysis - 2hrsOther

    Which Train-the-Trainer course(s) are you interested in? (check all that apply)
    Hazard Assessment - 2 daysWork Site Inspection - 2 daysIncident Investigation - 2 daysMIP Combo - 3 daysMIP SRH - 2 daysMIP MMH - 2 days

    Which Leadership course(s) are you interested in? (check all that apply)
    Safety Leadership I - 7hrsSafety Leadership II - 7hrsSafety Leadership III - 7hrsSafety Leadership Series - 3 days/21hrsOHSMS - 2 daysAuditor Training - 2 days

    **For help in determining who to send to training, please review the CCSA Course Participation Guidelines.

    Do you prefer private training for your organization?*(Important note: all training is delivered virtually by a CCSA Health and Safety Consultant via Zoom video conference.)
    Yes, participants from my organization onlyNo, participants allowed from other organizationsUnsure

    How many people would you like to register for the training?*(minimum number of 5 participants is required for on-site training)

    Participants are (please check that all apply):*
    Managers/SupervisorsHS Committee/RepresentativesFrontline Staff

    Will participants be from multiple sites or just one?*
    MultipleOne

    Will participants have their own computer?*
    Yes, each participant will have their own computerNo, participants will share one or more computersUnsure

    Please select your top 3 preferred dates for training. (We will try to accommodate your requested dates as CCSA resources allow.)*

    1st choice

    2nd choice

    3rd choice

    Anything else we should know?

    Cancellation Policy

    Full refunds will be given if Cancellation occurs up to 7 days before the event.
    CCSA may cancel/reschedule events due to unforeseen incidents or occurrences such as illness or outbreak, inclement weather, poor road conditions, etc.

    Thank you for your interest in CCSA safety training!
    A CCSA Safety Consultant will be in touch.

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    CCSA Edmonton
    110,6325 Gateway Blvd,
    Edmonton,AB T6H 5H6
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