Jamestown Community College’s Center for Continuing Education (CE) plans to apply for the New York State DOL Hazard Abatement Safety Grant for 2018-2019. The grant covers all instructional costs related to safety training. The grant covers activities from August 1, 2018 – July 31, 2019. CE wants to solicit local organizations to identify and provide safety training needs and would like to include you! If you are interested in participating, CE needs the following information as part of the grant application. Thank you for your time and interest.

* 1. Please provide your contact details

* 2. Please select "Yes" the trainings you’d like to offer below. Check the box if it is a high or low priority for your organization and if the training needs to be offered on-site at your location or if your employees can attend the training at an off-site location (JCC).

  Yes Priority High Priority Low On Site Off Site
Accident Investigation
Aerial Boom Lift Safety
AHA First Aid
Asbestos Awareness
Backhoe Safety
Bloodborne Pathogens
Confined Space (Entrant/Attendant)
Confined Space (Rescue)
Confined Space (Refresher)
Crane Safety
Electrical Safety
Emergency Evacuation
Fall Protection (Initial)
Fall Protection (Refresher)
Fire Extinguisher Safety
Fire Watch Safety
Forklift Safety
Hazard Assessment
Hazard Communication (Supervisors)
Hazard Communication (Right to Know)
Hazardous Waste Training (Site Worker Supervisor)
Hazardous Waste Training (Refresher)
Hearing Conservation
Heavy Equipment Safety
Hoist Safety
Incident Command
Laboratory Safety
Lockout/Tagout (Authorized)
Lockout/Tagout (Affected)
Machine Guarding
Manlift Safety
Material Handling
NFPA70E Electrical Safety
OSHA Construction Safety - 10 & 30 hrs
OSHA General Industry Outreach 10 & 30 hrs
Overhead Hoist Safety
Personal Protective Equipment (Initial)
Personal Protective Equipment (Refresher)
RCRA-Resource Conservation and Recovery Act/DOT (Initial)
RCRA-Resource Conservation and Recovery Act/DOT (Refresher)
Respiratory Protection (Initial)
Respiratory Protection (Refresher)
Rigging Safety (Initial)
Rigging Safety (Refresher)
Safety Program Development
Scaffold Safety (Multiple Use)
Scaffold Safety (Single Use)
Spill Awareness
Traffic Control (Initial)
Traffic Control (Refresher)
Workplace Violence (Supervisors)
Workplace Violence (Workers)

* 3. How many employees would your organization send to each of the following trainings? (Enter number of employees in box next to training topic - if 0, leave box blank)

* 4. Based on your responses to question 1, please list the job title(s) or department title(s) of the employees that your organization would send to the training (example: If you would send 5 employees to 'Crane Safety,' please provide the job title or department title of those 5 employees. Leave blank if you left training topic blank in question 1.

* 5. Did you have any reported accidents/incidences within the past three years?

* 6. If you answered yes to question #5, please include the past three years of accident/incident rate and list types of accidents and incidents reported.