Request for Voluntary Withdrawal of Application or Training Program

The Request for Voluntary Withdrawal of Application or Training Program form allows Training Provider applicants seeking Chief Prevention Officer (CPO) approval, or currently approved Training Providers to voluntarily withdraw their program(s). By submitting this for the requestor will forfeit their ability to offer the CPO approved health and safety program(s) listed.

Need help downloading or filling forms?

Please check our Help page for solutions to common issues.

Alert! Adobe is making changes that affect all PDF forms.

PDF Forms will no longer work with older versions of Adobe Reader including Adobe Reader XI. Please update your free Adobe Reader to the latest version from the Acrobat Reader download page so that you can continue to access these forms.

Forms, Links, and Information

Additional Information

Title Request for Voluntary Withdrawal of Application or Training Program
Description The Request for Voluntary Withdrawal of Application or Training Program form allows Training Provider applicants seeking Chief Prevention Officer (CPO) approval, or currently approved Training Providers to voluntarily withdraw their program(s). By submitting this for the requestor will forfeit their ability to offer the CPO approved health and safety program(s) listed.