Test - SEAA - Missouri Association of Manufacturers

Corporate Address: *

Line 1

Line 2

City

State

Zip Code

Country

Facility Address: *

Line 1

Line 2

City

State

Zip Code

Country

AWARD CATEGORIES

Select one award category per application. MAM Safety Excellence Award Committee reserves the right to change the award category for any application.

Award Categories *

Safety Innovation Award (Corporate, Multi-site or Single-site) Most Improved (Corporate, Multi-site or Single-site) Safety Manufacturing Company of the Year (Corporate, Multi-site or Single-site) Leader of the Pack (Corporate, Multi-site or Single-site) Horizon Award (Individual –or– Corporate, Multi-site or Single-site) Safety Champion of the Year (Individual) Safety Professional of the Year (Individual)

Company Data

Data represents (select one): *

Corporate (all facilities) Multi-site (two or more facilities) Single-site (one facility)

Full-time Employees *

Part-time Employees *

Percentage of Temporary Employees: *

Total hours worked (calendar year)

Number of recoverable nonfatal work-related injuries and illnesses (for MAM use only)

Number of days away from work cases
(for MAM use only)

Number of job transfer or restricted work activity cases

Experience Modification

2018 *

2017 *

2016 *

2018 SAFETY EXCELLENCE AWARDS APPLICATION

AWARD CATEGORIES

Company Data