After submitting your application you will need to provide the following to complete the process:

 Copy of written Safety and Health program
 Sample of employee training records
 Sample of disciplinary records
 Copy of site inspection documentation

Injury and Illness Logs
 (Year 2012) OSHA Form No. 300, 301 and 300A
 (Year 2013) to date OSHA Form No. 300, 301 and 300A


Signature: __________________________________________

Title: ______________________________________________


Please send to:
Michael Sicking, Safety International, ASA Safety Chairman

Email: [email protected]

Safety International
P.O. 6492
St. Louis, Mo. 63006