Application Form Internal Auditor Training

							                                                                                  BASE Internal Auditor
                                                                                   Training Application

                       Please complete this form and e-mail to training@bcforestsafe.org
                                        Questions? 1-877-741-1060
                                                   Course Type
            Location                                Date                           Apply by
             Surrey                             October 9 – 11                   September 24
            Nanaimo                             November 5 – 7                    October 19
         Prince George                         November 14 – 16                   October 31



                                             Student Information
                            Personal (Home) Information                   Company Information
Name

Address

City

Province

Postal Code

Phone Number

Email

Note: Please provide your Company WSBC # 

                                  Auditor Background Information
Complete the following information providing details on experience and listing designations,
training certifications, etc. Use additional pages or attach a résumé if necessary.
                                          Information                               Council use
                                                                                       only
Forestry
Industry
Work
Experience


Experience
in Current
Company




Application Form –BASE Internal Auditor Training                                   Last revised: August 31, 2012
                                                                                                     Page 1 of 2
     Safety
     Training
     and
     Experience




     Auditing
     Experience




     Education




     Participation in Internal Auditor Training - Classroom session & Student Audit:

     □        I confirm that I am an employee of this company or that they have declared me as a
              dependent contractor on their SAFE Companies registration.
     □        I understand that I can only conduct maintenance audits for my own employer.
     □        I will be available for 3 consecutive days of training at the location I have selected.
     □        I understand that the cost to students is $840.00 (includes HST).
     □        I will be available to perform my company’s internal maintenance audit (a 5 – 10 day
              commitment, depending on company size, including field work and report writing) within
              6 months of taking the course.


                                                          Declaration

I confirm that the above information is accurate:
                                                                    (Applicant’s Signature – digital acceptable)



                                                        Council Use Only
Comments:


Council Initials & Date:




     Application Form –BASE Internal Auditor Training                                            Last revised: August 31, 2012
                                                                                                                   Page 2 of 2