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Mine Safety

Online Submittals and Forms

Updated Traini​​ng Request Submission Process

As indicated in the DMS Training Request SubmissionProcess Industry Letter, effective January 1, 2026, all training requests are to be completed on the Training Request Form below and submitted to the Division of Mine Safety Director at ​Email Training Request.

DMS Forms Library
DownloadDescription
Training Request FormSubmit a request for training to the Division of Mine Safety. Complete form and submit via email as noted above.
Drug Test Reporting Form (DTR-1)Certification of a drug or alcohol violation.
Occupational Injury Form (EB-83)Notification of an accident or injury.
Mine License Application (EB-4)Application for a mine license.
Application for Miner Certification (EG-47)Application for miner certification.
MET Application for Initial Certification of Training (EF-18)Application for the 40-hour initial training course or challenge for renewal.
Application for MET Certification (EF-17)Application for persons who are EMT or EMT instructor certified that are exempted from challenging the MET examination.
MET Recertification of Training (EF-16)Recertification of training for an MET.
Certificate of Training (MSHA Form 5000-23)Certificate of training form as required by the U.S. Department of Labor, Mine Safety and Health Administration.
Mine Foreman, Asst. Forman, Instructor, and Inspector Application (EA-37)Application for surface and underground mine foreman and instructor, assistant foreman, and mine inspector.
Hoisting Engineer for Electrically Driven Hoist ApplicationApplication for hoisting engineer for electrically driven hoist.
Blaster Affidavit for Underground MinesAffidavit for conventional, solid blasting, or drill operator.
Electrical Worker Certification FormCertification requirements and forms for an electrical worker. Includes the required qualifications, experience, documentation, and affidavit.
Notification of Training Form (EF-13)Notification of training conducted by private and contract instructors.
Class Enrollment Form (EF-6A)Class enrollment form for private and contract instructors.
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