Thank you for your interest in UW Safety training.

Unfortunately, you are requesting a safety class that either is not currently scheduled or requires permission from the instructor.

Please complete all the information on yourself and the class being requested.

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Last Name: *
First Name: *
Email Address: *
Phone Number: *
Your W number (6 digits, including the "W"): *
Your Department: *
You Supervisor's Name: *
Name of the class you are requesting: *
Please tell us why you are requesting this class: *