REGISTRATION FORM: Webinar Basic Understanding of Working at Height

REGISTRATION FORM

Webinar: Basic Understanding of Working at Height.
Name*

First NameLast Name
Company Name*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
Industry*
How familiar are you with fall protection systems (e.g., lifelines, harnesses, anchors)?*

Very familiar – I use/implement them regularly.Somewhat familiar – I know the basics but not the details.Not familiar – I’m attending the webinar to learn more.
Have you or your team received training on fall protection systems?*

Yes, recently.No, we haven’t had any training.
Does your company currently use a fall protection system?*

Yes, we already have a system in place.No, we are exploring options.We are looking to upgrade our existing system.
What challenges do you face with fall protection in your workplace?*

Lack of training/knowledge.Inadequate equipment.Non-compliance with safety standards.High costs.Other (please specify)
What is your role in your company?*

Safety OfficerSite ManagerUserProcurement ManagerOther (please specify)
Do you have a budget allocated for safety equipment this year?*

Yes, already allocated.Not yet, but planning to allocate.No specific budget.
Signature*

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