to print and/or fax a registration form

1065 Ahua Street
Honolulu, HI 96819
Phone: 808-833-1681
FAX: 839-4167
Email: info@gcahawaii.org
Website: www.gcahawaii.org
Date & Time:
June 16 and 18, 2015
7:30 a.m. Registration
12:30 p.m. Ends
OSHA 10 Hour
For the Construction Industry
The OSHA 10 class is a Department of Labor OSHA authorized
course, which covers introduction to 29 CFR 1926.
Location:
GCA Conference Room
1065 Ahua Street, Honolulu
This course provides an overview of safety requirements for most
construction activities that will include and introduction to OSHA
and the following topics:
Cost:
$95 for GCA members
$130 for non-members
Please RSVP by
June 5, 2015.
Class space is limited and
reserved on a first come, first
served basis.
Please note!! If you cancel your
registration at least five (5) days
prior to the class, GCA will
provide a full refund. No refund
will be provided if you do not
meet this deadline, however you
may transfer your registration to
another employee within your
organization.
OSHA Focus Four Hazards,
(Fall Protection, Electrical,
Struck By, Caught in between)
Scaffolds, Fire Protection and
Prevention
Personal Protective and
Lifesaving Equipment,
Protective Structures and
Overhead Protection
Concrete and Masonry
Construction
Health Hazards in Construction
Hazard Communication
Excavations
Stairways and Ladders Safety
Confined Space Entry
Ergonomics
Materials Handling
Storage, Use and Disposal
Tools - Hand and Power
Welding and Cutting
Signs, Signals and Barricades
Silica
Cranes, Derricks, Hoists,
Elevators, and Conveyors
Please see attached for the registration form.
1065 Ahua Street
Honolulu, HI 96819
Phone: 808-833-1681
FAX: 839-4167
Email: info@gcahawaii.org
Website: www.gcahawaii.org
The General Contractors Association of Hawaii Presents:
OSHA 10 Hour
For the Construction Industry
June 16 and 18, 2015
Registration Form
If you did not receive a confirmation, please call 833-1681.
NAME:
Email:
NAME:
Email:
NAME:
Email:
NAME:
Email:
CONTACT:
Email:
Company:
Address:
City:
State/ZIP:
Phone/fax:
Cell:
LOCATION: The course will be held at GCA Conference Room, 1065 Ahua Street, Honolulu, HI 96819
TIME: 7:30 a.m. – 12:30 p.m.
PAYMENT INFORMATION: (Payment must accompany registration to secure seat)
Registration fee includes breakfast and Participant’s handout for the course.
Registration Deadline and Cancellation policy:
The registration deadline for this program is June 5, 2015. If you cancel your registration at least five (5)
days prior to the class, GCA will provide a full refund. No refund will be provided if you do not meet this
deadline, however replacement is accepted.
Registration Fee:
TOTAL:
o
$95 for members (bill company)
o
Enclosed is a check for
o
Charge credit card on file
o
Charge my credit card (See attached CC Form)
$
o
$130 for non-members
Make check payable to GCA of Hawaii
1065 Ahua Street
Honolulu, HI 96819
Phone: 808-833-1681
FAX: 839-4167
Email: info@gcahawaii.org
Website: www.gcahawaii.org
PLEASE FAX WITH YOUR
REGISTRATION FORM TO:
839-4167
CREDIT CARD AUTHORIZATION FORM
NAME ON CARD:
COMPANY:
BILLING ADDRESS:
CITY/STATE/ZIP
PHONE:
FAX:
AMOUNT:
CREDIT CARD TYPE:
rVISA
r MC
r AMEX
r DISCOVER
CARD NUMBER:
EXP. DATE:
CODE:
EVENT & LOCATION:
DATE OF EVENT:
SIGNATURE:
DATE:
CONTACT PERSON
r Check box to request credit card receipt to be emailed @ ____________________________
r Check box to request original credit card receipt to be mailed.
r Check box to request copy of credit card receipt to be faxed.
FOR GCA OFFICE ONLY:
RECEIVED BY:
DATE: