The reference form should be completely filled out. Those providing the reference should have personal knowledge of the applicants Safety and Health work activities. When finished click on the submit button at the bottom of the page. References may be mailed directly to ISHM (at the above address) or to the applicant for forwarding.
The applicant named below is seeking a professional certification by meeting academic and experience requirements, passing an examination, and receiving satisfactory references. Important information you provide as to the applicant’s qualifications will assist in making decisions for examination and certification. Your honesty and assistance in this matter is appreciated.