Form Approved
OMB Control Number 1225-0059
Expiration date: 02/29/2024
OSHA’s Beat the Heat National Contest Submission Form
Date: [text field entry]
Name of Representative/Point of Contact (First and Last Name): [text field for user entry]
Preferred Email: [text field for user entry]
Preferred Phone: [text field for user entry]
Company/Organization Name: [text field for user entry]
Company/Organization Type: [drop down: choose one]
Academia/Educational Center
Association/Trade Group
Government
Non-Profit
Private Citizen
Private Employer
Union/Worker Center
Other: [text field for user entry]
City: [text field for user entry]
State: [drop down: choose one]
Short description of product(s)/materials being submitted for contest: [text field for user entry]
PAPERWORK REDUCTION ACT
Public reporting burden for this voluntary collection of information is estimated to average 7 minutes per response, including time for reviewing instructions, searching existing data sources, gathering, and maintaining the data needed, and completing and reviewing the collection of information. OSHA will use this information to evaluate participation in the National Heat Contest. Persons are not required to respond to the collection of information unless it displays a current valid OMB control number. If you have any comments about this estimate or any other aspects of this data collection, including suggestions for reducing this burden, please send them to [email protected] or to US Department of Labor, OSHA Directorate of Standards and Guidance N-3609, 200 Constitution Avenue, NW, Washington, DC 20210.
Who is your intended target audience: [text field for user entry]
How would your target audience find or access your product(s)? [text field for user entry]
What attribute of your submission do you think makes it the most effective? [text field for user entry]
When workers/employers come across your product(s), what are you hoping they takeaway or learn? [text field for user entry]
URL Link to materials if currently available to public or are hosted on a website. You may submit more than one URL: [text field for user entry]
Terms and Conditions [check boxes- must check all]
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | Hernandez, Eduardo M - OSHA |
| File Modified | 0000-00-00 |
| File Created | 2024-07-24 |