SAFEty Culture Award Nomination Form

This award goes to a workplace with a positive safety culture. Workplaces with positive safety cultures ensure that:

safety and health concerns are addressed
leaders are committed to safety and health
trust and respect are essential in the work environment
everyone in the organization feels personally committed to and accountable for safety and health
the work environment is inclusive
includes continuous learning as a feature of the organization

Anyone can nominate a workplace for a SAFEty Culture Award.

Please complete the following form to nominate a workplace for the SAFEty Culture Award. We ask that you review our compliance criteria to make sure your nominee is eligible.

SAFEty Culture Award Nomination Form

"*" indicates required fields

Which workplace are you nominating?

Workplace name*

Workplace address*

City*

Postal code*

Contact person*

Phone number*

Email*

Nominator information:

First name*

Last name*

Job position*

Workplace name*

Workplace address*

City*

Postal code*

Phone number*

Email*

What has this workplace accomplished to earn a nomination for a SAFEty Culture Award?

Please answer these four questions to show how this workplace meets the requirements for this award.

What has this workplace accomplished to deserve a nomination for a SAFEty Culture Award?*

(max. 200 words)

Please provide at least one example showing how this workplace's leadership is committed to safety and health.*

(max. 200 words)

Please provide at least one example showing how this workplace works continuously to improve safety and health in the workplace.*

(max. 200 words)

Please provide at least one example showing how feedback about safety and health is welcomed from all job roles in the workplace.*

(max. 200 words)

SAFEty Culture Award Nomination Form

SAFEty Culture Award Nomination Form

Which workplace are you nominating?

Nominator information:

What has this workplace accomplished to earn a nomination for a SAFEty Culture Award?

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