Safety, Health & Environmental Professional
(SHEP) Application
A minimum of four courses must have been taken with MCC. Proof of completion must be
provided with this request.
Name:
Date Requested:
Street Address:
City:
State:
Zip:
Phone:
Email:
SAFETY, HEALTH, RISK MANAGEMENT and ENVIRONMENTAL
REQUIRED: (4)
EHSM 6036 – Introduction to Environmental Compliance and Management
RMSM 6010 – Safety, Health, and Environmental Risk Management Principals
EHSM 7900 – HAZWOPER 24
AND (1) of the following:
CSHO General Industry
CSHO Construction Industry
1
Application
(Page 2)
Send Request to:
Mail:
Region VII OSHA Education Center
Metropolitan Community College
ATTN: Alice Blea
1775 Universal Avenue
Kansas City, MO 64120
Fax:
(816) 482-5202
Email:
safety.first@mcckc.edu
Make checks payable to MCC – Indicate Certification Program and your Student ID#.
Certificate Fee: $95.00 Please note: to lock in the current Certificate fee you must complete
and submit the Application to Safety.first@mcckc.edu.
Charge to:
Visa
Master Card
Discover
Card Number
Exp. Date
Authorized Signature
Date
2