TCIA-Approved EHAP® Instructor Application Form

Tree Care Industry Association, Inc.

All TCIA-Approved EHAP® Workshop instructors must meet the following criteria.

Please check boxes and attach all required documentation.

Certifications

Documentation must be provided to show participation and success.

Provide at least one of the following to verify participation in each of the five training events: notices from program or conference brochures; training materials or rosters used for the training; training catalogs; contracts; and/or, five specific post-event testimonials or evaluations showing positive results

Applicant Contact Information
Name of Applicant    
Address 1    
Address 2    
State    
City    
Zip Code    
Company    
Email    
Phone    
Cell Phone    
Trademark Confirmation
  • I also recognize that the EHAP® manual and related videos are copyrighted by TCIA, Inc.
  • I agree not to reproduce these in any form without express written permission from TCIA.
  • I also agree that any workshops I facilitate that may be advertised as an “EHAP” training event, will only use the TCIA EHAP® program.
  • If I am involved with an electrical hazards training program that does not use the TCIA EHAP® program, it will not be advertised as an “EHAP” workshop and I will not advertise the credential of TCIA-Approved EHAP® Instructor in association with that training event.
  • I recognize that the credential of TCIA-Approved EHAP® Instructor can be removed by TCIA Inc. at any time with or without cause.
Signature    
Date