OhioBWC - Employer - Form: (Industry-Specific Safety) - Introduction

Application for Industry-Specific Safety Program (SH-28)

The Industry-Specific Safety Program (ISSP) offers a 3-percent rebate to eligible employers for using the services of BWC's Division of Safety & Hygiene. To learn more about eligibility and program requirements, go to the Program overview page.

Additional information
Program discount compatibility
The deadline for receipt of the program application is:
  • The last business day in May for the July 1 - June 30 program period - private employers only;
  • The last business day in November for the Jan. 1 - Dec. 31 program period - public employer taxing districts only.

Required information

  • Name of employer
  • Doing business as (DBA) name
  • Address
  • Federal tax ID number
  • Employer contact person
  • Employer contact telephone number
  • Email address to which BWC can send correspondence to industry-specific safety contact person
  • Name of designated employer representative and signature
Note: In addition to completing the application, you must submit the Safety Management Self-Assessment (SH-26). If your company has not submitted the SH-26 within the last 12 months for either the ISSP or another program, we will redirect you to the SH-26 to complete first, and then return you to the application.

If you have all the required information on hand, simply click the start button to begin.