OSHA Resource Center Loan Program
OSHA Directorate of Training and Education
Resource Center Loan Program
2020 S. Arlington Heights Road
Arlington Heights, Illinois 60005
Telephone: (847) 759-7736
email

  1. I will abide by the policies set forth in the policy statement.
     
  2. I understand that the copyright law of the United States (Title 17, U.S. Code) governs the reproduction of copyrighted materials. Private institutions, associations, and companies that are covered by this law produced most of the materials which are available for loan. I shall not duplicate or otherwise reproduce these materials without the expressed written permission of the producer.
     
  3. I understand that it is essential to return materials no later than the Due Date.
     
  4. If I lose or damage the materials, I will be responsible for replacement costs.
     
  5. Multiple late returns, or failure to submit payment for lost or damaged materials, will result in termination of borrowing privileges.
I have read and understood the above. I agree to comply with the rules and policies of the Resource Center Loan Program.

First Name: _______________________________ MI: _______ Last Name: _____________________________

Signature: _______________________________________________ Date: ____ /____ /___________________

Business Name: _______________________________________ Web Address: __________________________

Address: _________________________________________________________ Suite: ____________________

City: ___________________________________________ State: ________ Zip Code+4: __________________

Primary Phone: (____)_________________________ Alternate Phone: (_____)__________________________

Email: _________________________________________________ FAX Number: (_____)__________________

Indicate borrower category:
 
OSHA Outreach Trainer 
OSHA Training Institute Education Center
DTE Personnel 
OSHA Cooperative Program Member including SHARP,  VPP, Alliance, and Strategic Partnership
 
Federal OSHA
State OSHA
OSHA Consultation
Other Federal Agency Safety Personnel

______________________________________
                         (Agency Name)
 
Please complete all fields and submit the signed copy via First Class mail or email
(as scanned PDF attached).


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