MASS MARITIME ACADEMY
OSHA 10 HR General Industry Card Request Form

MASS MARITIME ACADEMY
OSHA 10 HR General Industry Card Request Form

Please fill out the form clearly and accurately to receive an OSHA card for the course named below. It is important to complete this form for tracking purposes. If you have any questions, please speak to the instructor.
COURSE SELECTION: YOU MUST SELECT ONE OF THE OPTIONS BELOW

  I would like to receive an OSHA 10 HR General Industry Wallet Card for a $50.00 fee.

  I would not like to receive an OSHA 10 HR General Industry Wallet Card for a $50.00 fee.



Name of Course: OSHA 10-HR General Industry
Course Number: Tuition: MMA-200152-CNE
Total Due: $50.00

Cadet Last Name:     

Cadet First Name:     

Middle Intitial:            

Contact Number:       

Email Address:           

Letter/Section:           

Date of 1st Session:   


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Disclaimer:

Wallet Cards are provided to students based on City, State, or Federal requirements of curriculum and training. Training does not absolve the worker or contractor of their full responsibility to work safely and comply with all required regulations. Training and Wallet Cards confirms receipt of approved training, not worker competence.

In conjunction with registering the above student, you are authorizing UASC to keep you updated on certification status and upcoming courses.

Cancellation Policy:

To obtain a refund minus a $15 non-refundable administrative cancellation fee, registrants need to notify UASC of cancellation within 10 business days before the end of the semester. Students must confirm their cancellation in writing.

No Refund will be given to registrants if they notify UASC of a cancellation less than 10 business days before the end of the semester, unless the course has been cancelled by United Alliance Services Corporation.