Training Assessment For Dangerous Goods/Hazmat

Company Name

Type of business/industry

Contact Person

Contact Phone Number

Email Address

Number Of Students

Date

Please list in order your priority (1 being the highest, 4 being lowest priority) for the following: Best Price, Timing, Compliance, Safety

Best Price

Timing

Compliance

Safety

When would you like the training to take place:
Within 1 month>1 month - 3 months>3 months - 6 monthsmore than 6 months

Level of training requested:
AwarenessCompetency and Function Specific TrainingTrainer LevelNot sure what we need

Are you involved with shipments by:
GroundAirMarineRail

Have you had previous training? If yes, which modes?
TDG - Transportation of Dangerous Goods49CFR - U.S. D.O.T. HazmatICAO/IATA - Dangerous Goods by AirIMDG Dangerous Goods by MarineRailClass 6.2 InfectiousClass 1 ExplosivesClass 7 RadioactivesNo, we have not had previous training

Are you involved with lithium batteries?
YesNoUnknown

Do you use any Special Cases in TDG?
YesNoUnknown

Do you have an Equivalency Certificate (Canada) or D.O.T. Special Permit (U.S.A.)? If yes, please email us a copy.
YesNoUnknown

Do you have a current non-compliance order or violation? If yes please email us a copy.
YesNoUnknown

Do you have a copy of the applicable Dangerous Goods or Hazmat Regulations?
YesNoUnknown

Would you like an onsite evaluation included with the training? Only available with Competency and Function Specific Training.
YesNo

Any other relevant information? Other comments:

**Please provide completed shipping documents and SDS (Safety Data Sheet) in advance of training.**

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