TRAINING CONNECT CARD REQUEST FORM

This field is for validation purposes and should be left unchanged.

GENERAL INFORMATION

Select a Card(Required)

Select the type of card you need/have.

Select a Service(Required)

If you are not sure, email us for help.

What company did you complete training with?(Required)

Training will be verified with the company.

Please type in the company you trained with below.(Required)

If you trained at multiple locations, add as many as you would like.

Total

PERSONAL INFORMATION

Name(Required)

Please make sure the name is correct and matches the name on your OSHA card.

First Middle Last

Date of Birth(Required)

Height(Required)

Eye Color(Required)

Mailing Address(Required)

Street Address Address Line 2 City State Zip code

Phone Number(Required)

Email(Required)

CERTIFICATIONS

Upload SST Card Photo

Please upload a photo of your SST card front and back.

SST Card FRONT(Required)

Accepted file types: jpg, png, pdf, heif, jpeg, pdf, heic, jfif, Max. file size: 2 GB.

SST Card BACK

Accepted file types: jpg, png, pdf, heif, jpeg, pdf, heic, jfif, Max. file size: 2 GB.

Upload OSHA 30 Card Photo

Please upload a photo of your OSHA 30 card front and back.

OSHA 30 Card FRONT(Required)

Accepted file types: jpg, png, pdf, heif, jpeg, pdf, heic, jfif, Max. file size: 2 GB.

OSHA 30 Card BACK(Required)

Accepted file types: jpg, png, pdf, heif, jpeg, pdf, heic, jfif, Max. file size: 2 GB.

PROFILE IMAGE

Upload Headshot Photo

Please upload a clear photo of your face with nothing in the background. Please do not upload an altered selfie or an image of your license. Please treat this like a passport photo.

Headshot photo(Required)

Accepted file types: jpg, png, pdf, heif, jpeg, pdf, heic, jfif, Max. file size: 2 GB.

CONFIRMATION & PAYMENT

Total

Confirm(Required)

I confirm that all the information above is true and that I am requesting an SST Card.

By checking the box above you are confirming that all the information you provided above is correct and true. You also confirm the request for an SST card. Please be advised that SST cards require a $40.00 processing fee or $25 if you completed training with NextWave, which can be made in cash or credit card and must be paid prior to card pickup or delivery.

Confirm(Required)

I confirm that all the information above is true and that I am requesting a renewed SST Card.

By checking the box above you are confirming that all the information you provided above is correct and true. You also confirm the request to renew your SST card. Please be advised that renewed SST cards require a $40.00 processing fee, which can be made in cash or credit card and must be paid prior to card pickup or delivery.

Confirm(Required)

I confirm that all the information above is true and that I am requesting to replace my SST Card.

By checking the box above you are confirming that all the information you provided above is correct and true. You also confirm the request to replace your SST card. Please be advised that replacing SST cards require a $50.00 processing fee, which can be made in cash or credit card and must be paid prior to card pickup or delivery.

New Card

Price:

New Card

Price:

RenewCard

Price:

RenewCard

Price:

Replace Card

Price:

Payment Method(Required)

Please select Credit/Debit. If you would like to pay cash, please call our office (212) 933-9071

Credit/Debit

Credit Card(Required)