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SAFETY PROFESSIONALíS INFORMATION SHEET
 

Atlantic Safety is now embarking on an aggressive expansion program to address the needs of our growing number of clients. We are in need of safety professionals on a project-basis arrangement who are capable of providing consulting work and training in areas such as occupational health and safety, industrial hygiene, fire protection engineering, ergonomics and other related fields. We give opportunities to qualified professionals who are interested and qualified to perform various consulting and training projects. 

We are looking forward to have you as part of a highly-motivated team of ASCI safety professionals. Apply online now! 

To allow us to evaluate your application, please enter all of the information requested below. Although we'll accept any application you send, submitting an application without all of the requested information may hinder our ability to evaluate your application fast.

Fields with
* needs to be filled up

First Name: *  Last Name : *
Nickname:   Position: *
Company Name: *
Company Address: *
City: *  Zip:
Phone: *  Fax:
Email: *
Date of Birth:   Place of Birth:

Certifications / Registrations / Others

DOLE / BWC Accreditation: Practitioner  Consultant 
Accreditation Number:
Expiration Date:
Other Professional Designations: 1.
2.
3.

Current Occupational Experience

Length of time in current position:  years:*  months:*
% of time to work in safety:

Industry Experience (see Industry Code List) : *

Indicate % of time in these safety functions:
% - identifying and evaluating hazardous conditions / practices
% hazard control design
% procedures and program development
% implementation and measurement

Previous Occupational Experience

1.   Position:  *
Industry Experience (see Industry Code List) : *
Length of time in position:  years:*   months:*
% of time to work in safety:
Indicate % of time in these safety functions:
% - identifying and evaluating hazardous conditions / practices
% hazard control design
% procedures and program development
% implementation and measurement
2  Position: 
Industry Experience (see Industry Code List) :
Length of time in position:  years:   months:
% of time to work in safety:
Indicate % of time in these safety functions:
% - identifying and evaluating hazardous conditions / practices
% hazard control design
% procedures and program development
% implementation and measurement

Degrees Received

College / University Name : 
Type of Degree Received : 
Date Graduated :

Areas of Specialty 

Other
(please specify)  : 

Industrial Safety   Risk Management  
Occupational Safety   Rescue Services
Industrial Hygiene   Environmental Management
Ergonomics   Training Program Development  
Emergency Medical Services   Loss Control  
First Aid   Construction Safety

Safety Related Training Attended

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