ISHM Certification Application Forms

ASHM Application Form:

The application will need to be completed in one session. If you close the application before completing it, no information will be saved and the application will have to be started over again. Once the application is completed print it for your records and then click on the Submit Button at the bottom of the last page.

Applications not completely filled out will not be considered.

Only provide an official, unopened, transcript from the institution granting the degree. (Copies will not be accepted.) Mail to:

Institute for Safety and Health Management
4841 East County 14 ¼ Street
Yuma, AZ 85365

Note: If application fee is paid by check or money order please mail to the address above.

After you have been designated an ASHM you may sit for the CSHM exam when you meet the experience criteria. The ASHM designation will become inactive if you do not sit for the CSHM exam within six years.

ASHM Application Form

Revised 12/2011

CSHM Application Form:

The application will need to be completed in one session. If you close the application before completing it, no information will be saved and the application will have to be started over again. Once the application is completed print it for your records and then click on the Submit Button at the bottom of the last page.

Applications not completely filled out will not be considered.

Your references can also electronically fill in the forms applicable to them and submit them in the same manner.

Only provide an official, unopened, transcript from the institution granting the degree. (Copies will not be accepted.) Mail to:

Institute for Safety and Health Management
4841 East County 14 ¼ Street
Yuma, AZ 85365

Note: If application fee is paid by check or money order please mail to the address above.

Once your CSHM application has been approved, you will be eligible to sit for the CSHM exam. The CSHM exam must be completed within one year of approval date. Exam procedures and requirements are listed on the website. You must notify the Institute and pay the examination fee at least 30 days prior to sitting for the exam.

CSHM Application Form

Reference for CSHM Application Form

Revised 12/2011

ASHM to CSHM Application Form:

The application will need to be completed in one session. If you close the application before completing it, no information will be saved and the application will have to be started over again. Once the application is completed print it for your records and then click on the Submit Button at the bottom of the last page. Prior to applying for CSHM certification, you must complete the required years of Professional Safety Work Experience.

Applications not completely filled out will not be considered.

Your references can also electronically fill in the forms applicable to them and email them in the same manner.

Once your CSHM application has been approved, you will be eligible to sit for the CSHM exam. The CSHM exam must be completed within one year of approval date. Exam procedures and requirements are listed on the website. You must notify the Institute and pay the examination fee prior to sitting for the exam.

ASHM to CSHM Application Form

Revised 12/2011

Feel free to Contact ISHM with any questions, or to request further information.