OSHA Training Reimbursement

Complete this form for OSHA online 10 hour or 30 hour training reimbursements.

If all requirements are met a check for the full price of the course ($99 for 10-hour, $199 for 30-hour) will be mailed to the company or individual within 2 weeks.

If you have any questions please contact us at 773-442-8260.

Fields marked with an * are required.

Check the training completed below *

Date of Registration *

Company *

Contact *

Contact Email *

Contact Phone

Participant’s Name *

Participant’s Email *

Course paid for by: *

Address to send reimbursement to: *

Upload the receipt for the course. Reimbursement will not be paid without proof of payment. *

20MB max

Upload the certification of completion. Reimbursement will not be paid confirmation of completion. *

20MB max

Please verify that you have checked the “I'm not a robot” checkbox.