TractorMower Operator Safety Training Workshop by cus77649

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									                     Registration Form




                                                                               RETURN SERVICE REQUESTED

                                                                                                          Ames, IA 50010-8664
                                                                                                          2711 S. Loop Drive, Suite 4700
                                                                                                          Institute for Transportation
                                                                                                                                           2010 Tractor/Mower Operator Safety Training Workshop
2010 Tractor/Mower
Operator Safety Training Workshop
Please print clearly and include complete address. Copy this form as needed.

 Name:


 Title:


 Mailing address:                                                                                                                                                                                          2010
 City, state, zip:                                                                                                                                                                                  Tractor/Mower
 Daytime phone:                                                                                                                                                                                     Operator Safety
 Email address:
                                                                                                                                                                                                  Training Workshop
SELECT LOCATION AND DATE
      Iowa City, IA—May 11, 2010
      Johnson County Shop
      4810 Melrose Ave. West
      Iowa City, IA
      Waukee, IA—May 12, 2010
      Maple Street Community Center
      445 Maple Street
      Waukee, IA
      Council Bluffs, IA—May 13, 2010
      Council Bluffs Fleet Maintenance Facility
      901 10th Ave
      Council Bluffs, IA 51501


Fee: $110/participant
Fee includes includes all handouts, refreshments during
breaks, and lunch.

Make checks payable to Iowa State University.

Please mail or fax this form and payment to
                                                                                                                                                                                                       May 11, 2010
                                                                                                                                                                                                       Iowa City, IA
Georgia Parham
Institute for Transportation                                                                                                                                                                           May 12, 2010
2711 South Loop Drive, Suite 4700                                                                                                                                                                       Waukee, IA
Ames, IA 50010-8664
Fax: 515-294-0467                                                                                                                                                                                      May 13, 2010
                                                                                                                                                                                                     Council Bluffs, IA
About the Workshop                                     Schedule                                           Instructor
The Tractor/Mower Operator Safety training             The workshop will be held in four Iowa locations   Jim Green has well-earned credibility, gained from
workshop is a one-day workshop on best safety          from May 11–13, 2010. Classes begin at 8:00 a.m.   over 20 years of experience. Jim is an OSHA-autho-
practices for industrial mower operator safety.        each day and will be completed by 3:30 p.m.        rized trainer and has achieved several other training
The workshop will include four hours of classroom      The locations are as follows:                      recognitions from the International/National Asso-
operator training and three hours of hands-on                                                             ciation of Safety Professionals, including Certified
                                                       May 11, 2010                                       Safety Training/Planning Specialist, Certified Safety
operator training, covering the topics listed below.
                                                       Johnson County Shop                                Trainer, Safety Manager, and Safety Auditor.
Classroom Training:                                    4810 Melrose Ave. West
  •	 Responsible operation                             Iowa City, IA
                                                                                                          Questions?
  •	 Safety management of hazards & risks              May 12, 2010                                       For questions about workshop content, contact
  •	 Before-operation safety                           Maple Street Community Center                      Tom McDonald, Safety Circuit Rider,
  •	 Operation safety                                  445 Maple Street                                   Institute for Transportation at 515-294-6384 or
  •	 Safety during shutdown                            Waukee, IA                                         tmcdonal@iastate.edu.
  •	 Safety practices during maintenance
                                                       May 13, 2010                                       For questions about registration, contact
Hands-On Training:                                     Council Bluffs Fleet Maintenance Facility          Georgia Parham, Events Coordinator,
 •	 Equipment inspection                               901 10th Ave                                       Institute for Transportation, at 515-294-8103 or
 •	 Safety signage placement                           Council Bluffs, IA 51501                           gparham@iastate.edu.
 •	 Use of checklists
 •	 Performance drivers test                                                                              Registration
 •	 Safe operating techniques                                                                             A registration fee of $110 includes all handouts,
 •	 Personal protective gear use                                                                          refreshments during breaks, and lunch.

Iowa Roads Scholar Program                                                                                Complete the attached form and mail or fax to

Attendance at this workshop will give you seven                                                           Georgia Parham
contact hours.                                                                                            Institute for Transportation
                                                                                                          2711 South Loop Drive, Suite 4700
                                                                                                          Ames, IA 50011
                                                                                                          Fax: 515-294-0467
                                                                                                          For online registration, visit
                                                                                                          www.ctre.iastate.edu/events/mower/

								
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