Application for Industry-Specific Safety Program (SH-28)
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| Introduction
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.
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| 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. |
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| If you have all the required information on hand, simply click the start button to begin. |
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