CHWCA Safety Award Application

CHWCA Safety Award Application

The CHWCA Risk Management Committee would like to hear about your safety ideas and solutions. The Cash for Safety Culture Program was established to promote a positive safety culture by recognizing and rewarding employees and agencies who take an active role in their agency’s safety program.

Submit your ideas and solutions by completing the form below and attaching the acknowledgement form (page 2 of the supervisor's instructions). We encourage you to submit your ideas and solutions as they arise. Use a separate application form for each submission.

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  • Please attach signed acknowledgement form. You may attach supporting documents as well. The link is to the form is

    Supervisor Instructions

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    Accepted file types: jpg, png, pdf, Max. file size: 50 MB.