Training Assessment For Dangerous Goods / Hazmat

Company Name

Contact Person

Contact Phone Number

Email Address

Number Of Students

Date Completed:

1) Type of business/industry

2) Courses Requested:
US HazmatAIR - ICAO/IATAInfectiousMarine - IMDGExplosivesTDG

3) When Do You Want The Training Conducted?
< 1 Month1 Month - 3 Months3 Months - 6 Months> 6 Months

4) Previously Trained? Which Modes?
Ground/SurfaceRailMarine/IMDGAir - ICAO/IATA

5) Length Of Course Requested:
Estimate Full-DayMulti-Day

6) Which Classes / Types Of Dangerous Goods / Hazmat Should We Focus On?
12.12.22.334.14.24.35.15.26.16.2789

7) What Means Of Containment Or Packaging Should We Focus On?
TankersTanks - PortableIBCSacksDrumsBoxesCylindersOther

a.) Do You Ship Using Any Exemptions?
YesNo

b.) Which Ones?
LTD QTYM.O.T.Other

9) Is Your Company Involved In:
ShippingReceivingTransportingHazardous WasteHandlingImportingExportingLogistics/Freight Forward

10) Any Specific Areas To Address?

11) Do You Use A DOT Exemption?
YesNo

12) Do You Have A Current Non-Compliance Order Against Your Company?
YesNo

13) Do You Have A Copy Of The Applicable Hazmat Or Dangerous Goods Regulations?
YesNo

14) Would You Like The Class To Do An Onsite Tour If Training Is Held At Your Location?Not Applicable if this is a webinar!
YesNo

By completing this form you consent to being added to our mailing list.