Registration Form

Registrations are taken on a first-come, first-served basis.

Before you begin, click here for tips on filling out this form. A new browser window will open so you can switch back and forth between the two windows to receive help on how to fill out the form.

Field names with an asterisk (*) must be filled in to complete your online registration.

*Contact Person:
Company:
*Phone:(   Ext:
Fax:(
*Address:
Address 2:
Apt./Suite:
*City:
State:
*Zip: -
Email Address:
UBI Number: (no dashes — example: 123456789
Account Number: (an 8-digit number with no dashes)

Please Note: The workshop schedules listed in the drop-down menus below are updated automatically. If a class is not listed, it is either full or canceled. Also, we request that you register at least a week in advance. If you would like to register for a workshop sooner than a week in advance, please contact Chris Ver Eecke at verc235@Lni.wa.gov or call 360-902-4419.

Course Number

  • Select the course from the menu below.
  • Type a dash (-) to move to the next workshop in the list
City: Date: Time: Course #

Names & Email Addresses of Participants for these Choices

  • Type a semicolon (;) after each name & email address: (i.e.: John Smith JohnSmith@xyz.com; Jane Doe Jane@mywebhost.com; etc.)
*
 
City: Date:Time:Course #


If you have a disability and require accommodations to access this event:

  • Please register at least four weeks in advance
    AND
  • Indicate special accommodations required

Type any special requirements in the space provided below.  You can also use the space below to write any other questions, comments or to provide special instructions:

Please indicate how you learned about L&I’s workshops: 

Social media (Facebook/Twitter/etc.)
Received the workshop catalog in the mail.
Read about workshops in a newspaper.
Saw an advertisement.
Business or trade association provided info.
Talked with someone who works for L&I.
Saw information on L&I’s Internet web site.
Other: 

Place a checkmark by the mailing lists to which you want your name added. 

Workshop schedule
Governor’s Safety and Health Conference
Safety and Health Video Library


Please contact Chris Ver Eecke at verc235@Lni.wa.gov or call 360-902-4419, if you have any questions about this workshop.

*Submitting this online form is a request to be registered in the selected workshop. You are not registered until you receive a written confirmation.*

If your choices are already full you will automatically be:

  • Registered for the next available workshop in your area
    OR
  • Placed on a waiting list for your area.

Now that you have finished filling out the form, you can print the completed form before you click on the "Submit Workshop Registration" button below. If you want to print a copy, click here. Otherwise, click the button below to submit your registration.

Click to send your registration form

Click to clear your registration form

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