Registration Form For Renewal of Safety and Health Officer (SHO)

DEPARTMENT OF OCCUPATIONAL SAFETY AND HEALTH
Website : http://www.dosh.gov.my

CHECKLIST FOR RENEWAL OF REGISTRATION AS
SAFETY AND HEALTH OFFICER (SHO)
Applications should be addressed to:
Director General,
Department of Occupational Safety and Health,
Level 2, 3 & 4, Block D3, Complex D,
Federal Government Administrative Centre,
62530 Federal Territory of Putrajaya.
(ATT: Director of Industrial Safety Division)

Name of applicant : ________________________
Phone No

: ________________________

Email

: _________________________

The following information is required (information should be in the order below): NO.

YES
(√)

ITEM

1.

Copy of N.R.I.C.

4.

NOTE

The original Certificate of Registration Book (Green Book).

3.

OFFICE USE

A letter from the applicant's mailing address along with the latest along with phone numbers and email addresses.

2.

NO
(X)

Renewal Application Form (Schedule II) properly filled.

5.

6.

Two (2) recent driving license photographs (for the second Certificate of Registration Book (Green Book))
Please write your name, N.R.I.C. No. and SHO posts in the background. A processing fee of RM 50.00 in the form of:
i. E-Payment – Internet online RHB bank (please attach a copy of the payment receipt) ii. Cash – only at JKKP Head Quarters iii. Money order / postal order / bank draft in the name of the
Director General of DOSH MALAYSIA

7.

Letter of confirmation / support from employer confirming the applicant has served as a safety and health officer.

8.

Table points calculation system according to the ‘Garis Panduan
Sistem Mata Bagi Program Pendidikan Berterusan’.
(Attached with the copy of certificate of 'continuous education program' attended in the registration or renewal and related evidence) Department of Occupational Safety and Health |

1/2

9.

10.

DEPARTMENT OF OCCUPATIONAL SAFETY AND HEALTH
Website : http://www.dosh.gov.my
Employer