For professionals and businesses prioritizing safety in the workplace, the Daftar NIOSH form serves as a critical tool in ensuring adherence to occupational safety and health standards. As a comprehensive application for the NIOSH Safety Passport Course and Assessment, it encompasses a wide range of important details required from applicants. This includes preferred training venues spread across various locations, from Bangi to Kota Kinabalu, ensuring accessibility for participants nationwide. It equally delves into specifying information pertaining to the course and assessment applications, whether it's a first-time application, a re-sit, or renewal, alongside the desired course among options like OGSP for oil and gas safety and NTSP for electrical safety, revealing its intention to cater to diverse industry needs. Notably, it mandates particulars regarding the applicant, such as personal information, emergency contacts, and sponsorship details, highlighting the program's thoroughness in registration. Payment information and important reminders also form part of this form, emphasizing the procedural aspects and the necessity for compliance with specific instructions, like the prohibition against photocopying the form, to ensure a smooth and orderly application process. By also providing information on where to send the completed application, the form not only facilitates an understanding of the course and assessment enrollment process but also underscores the importance of safety training in fostering secure working environments.
Question | Answer |
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Form Name | Daftar Niosh Online Form |
Form Length | 2 pages |
Fillable? | No |
Fillable fields | 0 |
Avg. time to fill out | 30 sec |
Other names | ogsp online check, niosh kerteh online, niosh online, renew ogsp online |
NIO
INSTITUT KESELAMATAN DAN KESIHATAN PEKERJAAN NEGARA
NATIONAL INSTITUTE OF OCCUPATIONAL SAFETY AND HEALTH
BORANG PERMOHONAN KURSUS DAN PENILAIAN PASPORT KESELAMATAN NIOSH
NIOSH SAFETY PASSPORT COURSE AND ASSESSMENT APPLICATION FORM
TEL : 03 - 8769 2100 |
FAX : 03 - 8926 2900 |
URL : www.niosh.com.my |
Peringatan! Borang ini tidak boleh difotokopi. Hanya borang yang dicetak sahaja diterima. Remember! This form cannot be photostated. Only printed form will be accepted.
A. TEMPAT LATIHAN PILIHAN PREFERRED TRAINING VENUE
Tandakan atau tuliskan dalam petak yang berkenaan
Mark or write in the appropriate box
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BANGI |
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MELAKA |
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KOTA KINABALU |
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PULAU PINANG |
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BINTULU |
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KUCHING |
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KEMAMAN |
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JOHOR BAHRU |
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B. MAKLUMAT PERMOHONAN |
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C. MAKLUMAT ULANGAN PENILAIAN |
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APPLICATION’S INFORMATION |
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ASSESSMENT |
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KALI PERTAMA FIRST TIME |
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KALI KEDUA SECOND TIME |
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PEMBAHARUAN RENEWAL |
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KALI KETIGA THIRD TIME |
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TARIKH KURSUS : |
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TARIKH PENILAIAN : |
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dd/mm/yyyy |
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dd/mm/yyyy |
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D. KURSUS PILIHAN APPLIED COURSE |
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OGSP |
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NTSP |
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VERSI MODUL MODULE VERSION |
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Pasport Keselamatan |
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Pasport Keselamatan |
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NTMSP |
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NOSP |
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Pasport Keselamatan |
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Pasport Keselamatan |
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SILA NYATAKAN PLEASE STATE : |
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BAHASA INGGERIS ENGLISH |
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*BAHAGIAN E & E1 HANYA DIISI OLEH PESERTA KURSUS
E.KURSUS PILIHAN MENGIKUT JENIS PEKERJAAN (APPLIED COURSE BY WORK TRADE)
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CSPS |
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NNSP |
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Contractors Safety Passport System |
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E1. JENIS PEKERJAAN WORK TRADE
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KERJA AM |
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KERJA SAJIAN |
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PENGENDALIAN KIMIA |
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KERJA PEMBERSIHAN |
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GENERAL WORK |
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ELECTRICAL WORK |
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CATERING WORK |
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CHEMICAL HANDLING |
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HOUSEKEEPING |
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KERJA SIVIL |
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PENGENDALIAN BAHAN |
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LANDSCAPE WORK |
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MATERIAL HANDLING |
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TRANSPORTATION SAFETY |
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F. MAKLUMAT PEMOHON APPLICANT’S INFORMATION |
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NAMA PEMOHON |
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APPLICANT’S NAME |
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NO. MYKAD |
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IC NO. @ PASSPORT NO. |
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D.O.B dd/mm/yyyy |
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WARGANEGARA |
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UMUR |
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NATIONALITY |
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AGE |
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JAWATAN |
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JANTINA |
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POSITION |
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GENDER |
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FEMALE |
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NO. TELEFON |
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JENIS DARAH |
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TELEPHONE NO. |
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BLOOD TYPE |
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NO. FAKSIMILI |
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ALAHAN |
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FACSIMILE NO. |
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ALLERGIES |
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NO. TEL. BIMBIT |
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ALAMAT |
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WARIS TERDEKAT |
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IMMEDIATE FAMILY MEMBER |
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NO. TELEFON |
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HUBUNGAN |
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KECEMASAN |
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RELATIONSHIP |
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EMERGENCY CONTACT NO. |
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NAMA UNTUK DICETAK
DI ATAS KAD
NAME TO BE PRINTED ON THE CARD
G. MAKLUMAT PENAJAAN SPONSOR’S INFORMATION
Tandakan atau tuliskan dalam petak yang berkenaan
Mark or write in the appropriate box
PENAJA SPONSOR
NAMA SYARIKAT COMPANY NAME
ALAMAT
MAILING ADDRESS
BANDAR CITY
POSKOD POSTCODE
PEGAWAI BERTANGGUNGJAWAB
PERSON IN CHARGE
NO. TELEFON TELEPHONE NO.
COP RASMI SYARIKAT
COMPANY OFFICAL STAMP
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TAJAAN SENDIRI |
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TAJAAN SYARIKAT |
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COMPANY SPONSORED |
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NEGERI STATE
..............................................................
TANDATANGAN PENAJA
SIGNATURE OF SPONSOR
TARIKH
DATE
H. MAKLUMAT PEMBAYARAN PAYMENT INFORMATION
HARGA KURSUS / PENILAIAN
COURSE / ASSESSEMENT FEE
KAEDAH PEMBAYARAN
PAYMENT METHOD
R |
M |
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0 |
0 |
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TUNAI |
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CEK |
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NO. CEK |
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CASH |
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CHEQUE |
CHEQUE NO. |
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KAD KREDIT |
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KIRIMAN WANG |
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DRAF BANK |
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CREDIT CARD |
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MONEY ORDER |
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BANK DRAF |
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BAYARAN SECARA ONLINE (MAYBANK2U) |
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ONLINE PAYMENT (MAYBANK2U) |
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TANDATANGAN PEMOHON
APPLICANT’S SIGNATURE
PENTING IMPORTANT
TARIKH
DATE
1.Sila pastikan cek dibayar atas nama “NIOSH”. No akaun NIOSH : 5122 6840 2410 (Maybank, Cawangan Bandar Baru Bangi).
Please ensure cheque payable to “NIOSH”. NIOSH account no. : 5122 6840 2410 (Maybank, Bandar Baru Bangi Branch).
2.Jangan hantarkan wang tunai menerusi surat/ pos. Do not send cash through mail.
3.Sila bawa bersama SEKEPING FOTO berukuran pasport dan SATU salinan MYKAD/ PASPORT semasa hari pendaftaran. Please bring along during registration day ONE passport size photo and ONE copy of MyKad/ Passport.
4.Sila pastikan ruangan JENIS DARAH dan TARIKH LAHIR telah diisi.
Please ensure BLOOD TYPE and DATE OF BIRTH column has been filled up.
5.NIOSH berhak untuk menolak permohonan yang tidak lengkap. NIOSH has the right to reject incomplete application.
6.Borang ini tidak boleh difotokopi. Hanya borang yang dicetak sahaja diterima. This form cannot be photostated. Only printed form will be accepted.
SILA HANTARKAN BORANG PERMOHONAN YANG TELAH LENGKAP KEPADA :
PLEASE SEND COMPLETE APPLICATION FORM TO :
Ibu Pejabat NIOSH, (Selangor)
Tel : 03 - 8911 3822/ 3825/ 3824/ 3826
Faks : 03 - 8926 3900
Pejabat Wilayah Selatan
Tel : 07 - 599 1200 (Johor) 06 - 351 6900 (Melaka)
Faks : 07 - 599 0200 (Johor) 06 - 351 6800 (Melaka)
Pejabat Wilayah Utara (P. Pinang)
Tel : 04 - 380 1200
Faks : 04 - 397 3977
Pejabat Wilayah Sarawak
Tel |
: 086 - 311 500/ 330 600 (Bintulu) |
||||
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: 082 - 256 |
500/ 241 |
800 (Kuching) |
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: 085 |
- 406 |
085/ 071 |
(Miri) |
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Faks |
: 086 |
- 315 |
501 |
(Bintulu) |
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: 082 |
- 253 |
020 |
(Kuching) |
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: 085 |
- 406 |
086 |
(Miri) |
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: sarawak@niosh.com.my |
Pejabat Wilayah Pantai Timur (Kemaman)
Tel : 09 - 859 9961
Faks : 09 - 859 9960
Pejabat Wilayah Sabah & W.P. Labuan (Kota Kinabalu)
Tel : 088 - 264 252
Faks : 088 - 263 252