Client form for Mobile Crane Supervisor Delivery Plan

Delivery Plan - Crane Supervisor for Mobile Cranes

We are looking forward to delivering the Crane Supervisor for Mobile Cranes course to your staff.

To plan the delivery we need some information from you. Please complete the form below and we will create a Delivery Plan that you can use to inform your trainees and other key staff members.

If you have any questions please contact Kim Chard at (604) 398-5230 or kim@fulford.ca.

Thanks for you help!

Admin

Booking Reference Number(Required)

Please copy/paste the reference # provided in the email with the link to this form.

Company Name(Required)

Company Billing Address(Required)

Street Address City Province Postal Code

Email for Digital Record of Training(Required)

Please provide an email address where you would like to receive a digital record of the trainee's results after the training is complete. Digital wallet cards will be emailed to the participants

Participant names.(Required)

Day 1 - Level 1 Rigging

Preferred Start Time (8 hr day; Regular start time 8am)

Hours

Minutes

AM/PM

Is lunch is provided for the class?(Required)

If "Yes" you will be asked to provide the time so our trainer can plan accordingly.

Yes

Lunch Delivery Time(Required)

Hours

Minutes

AM/PM

Location of Morning Classroom Portion(Required)

Meeting or training room that can accommodate all participants and the Instructor with tables and chairs for the delivery of the theory portion of the course. A lunchroom, boardroom or similar space can be used but must be closed to staff who are not taking the training.

Same as Company Billing Address

Street Address City Province Postal Code

Morning On-Site Contact(Required)

Cell Phone(Required)

Email(Required)

For the classroom portion, is there a monitor with HDMI capability or a projector+screen available?(Required)

(If no, the Instructor can provide)

Yes

Location of Afternoon Practical Portion(Required)

The hands-on section of the training requires access to a work area (yard, warehouse, etc) that is away from active operations on the site and has room for hoisting equipment and to rig loads.

Street Address City Province Postal Code

Afternoon On-Site Contact(Required)

Cell Phone(Required)

Email(Required)

Make & Model number of lifting device being used for training(Required)

The Make and Model number can be found on the load chart or on the front of the device manual. For example: Hiab 088 XS

Please attach a photo of the lifting device.

If you do not have access to a photo of the device now, please follow up with it later.

Max. file size: 256 MB.

Please attach the lifting device manual or load chart, if available.

Drop files here or

Max. file size: 256 MB.

Is the lifting device a crane that requires operator certification to run?(Required)

Mobile cranes, boom trucks, and tower cranes with a rated capacity equal to or greater than 5 US Tons (4.54 tonnes) or with a boom length equal to or greater than 25 feet (7.62 meters) require operator certification to run. If you are unsure about your device please contact us to confirm.

Yes

If you answered "Yes" above, the crane needs an up-to-date annual inspection (NDT) and a certified operator available to run the crane for the afternoon session. If the annual inspection is out of date and/or there is not a certified operator available, the Instructor will have to terminate the training. PLEASE READ AND CONFIRM BELOW:(Required)

1. The crane has up-to-date annual inspection (NDT), and documentation or certification sticker will be available for review when the Instructor gets to site.

2. The manufacturer’s manual, load charts, up-to-date logbook, stability charts and engineering will be available when the Instructor gets to site.

3. There will be a certified operator available to run the crane for the afternoon session.

Yes, I confirm all of the above.

If you answered "No" above, please note that if an excavator, loader, forklift, telehandler or other alternate piece of equipment is being used, then an engineered and certified lifting attachment must be available as well as capacity charts for the machine and attachment.(Required)

PLEASE CONFIRM BELOW:

Yes, an excavator, loader, forklift, telehandler or other alternate piece of equipment is being used, and an engineered and certified lifting attachment, as well as capacity charts for the machine and attachment will be available when the Instructor gets to site.

No, an excavator, loader, forklift, telehandler or other alternate piece of equipment is not being used.

At the afternoon training site is there rigging in good condition and a load over 100 lbs but less than 50% of the hoist’s capacity available.(Required)

Yes

Days 2-4

Preferred Start Time (8 hr day; Regular start time 8am)

Hours

Minutes

AM/PM

Is lunch is provided for the class?(Required)

If "Yes" you will be asked to provide the time so our trainer can plan accordingly.

Yes

Lunch Delivery Time

Hours

Minutes

AM/PM

Location of Classroom(Required)

Note: Day 2-4 are all in-class. Meeting or training room that can accommodate all participants and the Instructor with tables and chairs for the delivery of the theory portion of the course. A lunchroom, boardroom or similar space can be used but must be closed to staff who are not taking the training.

Same as Company Billing Address

Street Address City Province Postal Code

Morning On-Site Contact(Required)

Cell Phone(Required)

Email(Required)

Is there a monitor with HDMI capability or a projector+screen available?(Required)

(If no, the Instructor can provide)

Yes

Are there any special parking/site access requirements (including things like site access passes or site orientations) or any special directions if the site is hard to find?(Required)

General Notes

Certifications

Other Services

About Fulford

Delivery Plan - Crane Supervisor for Mobile Cranes

We are looking forward to delivering the Crane Supervisor for Mobile Cranes course to your staff.

To plan the delivery we need some information from you. Please complete the form below and we will create a Delivery Plan that you can use to inform your trainees and other key staff members.

If you have any questions please contact Kim Chard at (604) 398-5230 or kim@fulford.ca.

Thanks for you help!

Admin

Day 1 - Level 1 Rigging

Days 2-4