OHIO SAFETY COUNCIL ENROLLMENT FORM | 2023-2024
BWC’s Division of Safety & Hygiene co-sponsors safety councils to provide Ohio employers with access to occupational safety and health, workers’ compensation and risk management education, networking, and resource sharing. In completing this enrollment form, the employer makes a commitment to send representatives to monthly safety council meetings put on by the Greater Cincinnati Safety Council.
Enrollment Date
*
Employer Name
*
i.e., Company Name
Employer Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Email Address
*
example@example.com
BWC Policy Number
*
Name
*
First Name
Last Name
Title
*
i.e., Job Title
Signature
*
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Submit
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