Title Please Select Miss Ms. Mrs. Mr. Dr. First Name*First Name is Required Last Name*Last Name is Required Address City Province*Province is required Please Select AB BC MB NB NL NS NT NU ON PE QC SK YT =============================== AL AK AZ AR CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Postal Code*Postal Code is Required Email Address* Invalid email Email Address is Required Confirm Email Address* Invalid confirm email Email addresses do not match. Preferred Telephone What is the best time to call you if necessary? Fax Number What is the name of your company or organization?*Company/Organization name is required How many employees? Is your company/organization unionized?

Yes

No

If yes, which Union? Please Select 27086d40-4dca-df11-9aab-000c291334ba Air Line Pilots Association-International Alliance Employees Union Alliance of Canadian Cinema, Television & Radio Artists Association des enseignantes et des enseigants franco-ontariens Association of Management, Administrative and Professional Crown Employees of Ontario Association of Professional Student Services Personnel Bakery, Confectionery, Tobacco Workers and Grain Millers' International Union British Columbia Teachers' Federation Canadian Actors Equity Association Canadian Association of University Teachers Canadian Labour Congress Canadian Media Guild Canadian Postmasters and Assistants Association Canadian Union of Public Employees Local 1000 Power Workers Union Canadian Union of Skilled Workers Communication Workers of America Educational Resource Facilitator of Peel Glass, Molders, Pottery, Plastics and Allied Workers International Union International Alliance of Theatrical Stage Employees International Association of Fire Fighters International Association of Heat and Frost Insulators and Allied Workers Local 95 International Brotherhood of Boilermakers Canada International Brotherhood of Teamsters International Federation of Professional and Technical Engineers International Longshore and Warehouse Union International Plate Printers, Die Stampers and Engravers' Union of North America International Union of Bricklayers and Allied Craftworkers International Union of Elevator Constructors International Union of Operating Engineers International Union of Painters and Allied Trades Ironworkers Union Labourers International Union of North America Major League Baseball Players Association Millwrights Regional Council of Ontario Local 1592 National Hockey League Players' Association Ontario Professional Firefighters Association Ontario Public Service Employees Union Ottawa Newspaper Guild Practical Nurses Federation of Ontario Professional Institute of the Public Service of Canada Sheet Metal Workers' and Roofers' International Association Local 562 Shipyard General Workers' Federation of British Columbia Society of United Professionals Toronto Musicians Association Toronto Professional Firefighters Association UNIFOR United Association United Association of Plumbers and Pipefitters Local 800 SSM United Brotherhood of Carpenters and Joiners Local 1946 United Steelworkers Are you a WHSC-qualified instructor?

Yes

No

Are you a JHSC member or worker rep?

Yes

No

Are you a graduate of WHSC Training?

Yes

No

Work Environment*Work Environment is required Please Select Care facility/home Construction Correctional Facility Emergency services Factory/processing plant Farm Hospital Hotel, restaurant or bar Laboratory Mine Mobile (eg: sales/installation) Office Park or recreational facility Print shop Repair shop School/college/university Store or salon Transportation - Air Transportation - Rail Transportation - Road Transportation - Water Utility/treatment plant Warehouse Work from home Other Why do you require this information?*Required information Please Select Delivery of WHSC Training JHSC / Worker Rep Functions Legal Compliance Workplace Hazard Other If Other please specify When do you require this information? MM/DD/YYYY Your inquiry or question