REVISED 01-2018
State of West Virginia
WV Office of Miners’ Health, Safety & Training
Greg Norman, Director
# 7 Players Club Drive – Suite 2 ▪ Charleston, West Virginia ▪ 25311-1626
Telephone 304-558-1425 ▪ Fax 304-558-1282
www.wvminesafety.org
Since 2002, the West Virginia Office of Miners’ Health Safety and Training has provided as a public service a listing on our web site of Certified Instructors of miner training classes. We would like to expand this listing to include Certified Instructors of Continuing Education for Underground Mine Foreman (CEUMF).
In order for us to maintain a current list we need you to provide the following information:
Are you currently offering miner training classes to the public? ______Yes or No (required)
Are you currently offering continuing education for underground mine foreman (CEUMF) training classes to the public? ______Yes or No (required)
Only those offering classes to the public will be listed on our website as a public service.
Certified Instructor Name:
80-Hour Certification Number
40-Hour Certification Number
CEUMF Instructor Certification Number
Name of Business:
Business address:
County (where classes are taught)
Daytime Business Phone: (required)
Email Address: (required)
Signature Date
Please complete this form and return it within 10 days (mail, fax, or email) to:
West Virginia Office of Miners’ Health Safety and Training
Attn: Instructor Update
#7 Players Club Drive – Suite 2
Charleston, WV 25311-1626
Fax: 304-558-1282
Email:
REVISED 01-2018
▪ Region One ▪ 14 Commerce Drive, Suite 1 – Westover, West Virginia 2650 ▪ Telephone 304-285-3268 ▪ Fax 304-285-3275
▪ Region Two ▪ 891 Stewart Street - Welch, West Virginia 24801-2311 ▪ Telephone 304-436-8421 ▪ Fax 304-436-2100
▪ Region Three ▪ 137 Peach Court - Suite 2, Danville, West Virginia 25053 ▪ Telephone 304-369-7823 ▪Fax 304-369-7826
▪ Region Four ▪ 550 Industrial Drive- Oak Hill, West Virginia 25901-9714 ▪ Telephone 304-469-8100 ▪ Fax 304-469-4059