NUCA 2025 Trench Safety Stand Down Submission Form

Please submit this form to receive your certificate of completion and hard hat stickers.

Your certificate of completion will be automatically generated and sent electronically to the email you provide below. Please review your entered information carefully.
If hard hat stickers are requested, they will be mailed to the address you provide below.
Once the stand-down has been completed, materials will be sent out after June 20, 2025.
Please allow at least two weeks for processing time from your submission date.

If your company held multiple events in different locations (city, state):

Submit this form for each stand-down event location.
Do not combine forms.
If you have photos of your event, please email them to edward@nuca.com.

If you have any questions about filling in the information below, please get in touch with Ed DeNeale, Director of Safety via email: edward@nuca.com.

Contact Name*

First NameLast Name

E-mail - Where would you like your certificate emailed?*

example@example.com

Phone Number

Company Name - How would you like your company name to appear on your certificate?*

Address - This is the address NUCA will send requested Hardhat Stickers to.*

Street Address

Street Address Line 2

CityState

Zip Code

Event Start Date*

Event End Date*

Event City:*

Event State:*

Total Number of Employees that participated:*

Must be a number.

Would you like to request 2025 TSSD Hard Hat stickers for those that participated?*

YesNo

How many stickers would you like mailed to the address indicated above?

Do you have photos to share of the event? Upload them here or send them to edward@nuca.com

-PDFs, JPEGS, PNG Files

How did you share trench safety information during your stand down?

Company Description*

Contractor / Excavator (Utilities, Dirt)Associate (Industry Supplier)Institution (government agency, municipality, school)Other Specialty ContractorOther

NUCA Member?*

YESNO - But I am interested in joining NUCA. Send me materials electronically!NO - I am not interested in joining NUCA.

2025 TRENCH SAFETY STAND DOWN COMPLETION FORM