MSHA Instructor Training Interest Form

Use this form only to state your interest in joining a potential future course.

MSHA Instructor (Train-the-Trainer) courses are offered only when a minimum number of interested parties is reached. At that point, all interested parties on the waitlist will be notified with instructions on how to register.

If you are interested in pursuing your MSHA Instructor certification with us, please complete and submit the form to the right, and we will send you a confirmation email and keep you informed of our MSHA Instructor course offering.

Tentative Future Training Dates

April 20-22, 2027

August 17-19, 2027

Name

Email Address

Phone Number

Total Years of Experience at Part 48 Mines

Your Part 48 Certifications (check all that apply) Your Part 48 Certifications (check all that apply) Surface Metal Surface Nonmetal Surface Coal Underground Metal Underground Nonmetal Underground Coal

Company/Employer

Company/Employer Address

Preferred Training Dates (check all that apply) Preferred Training Dates (check all that apply) April 20-22, 2027 August 17-19, 2027

12 + 11 =