Central Piedmont Safety Council s1

Registration Form

Central Piedmont Safety Council

Effective Safety Committees Workshop

Wednesday, September 16, 2009

Registration at 8:00 AM, Workshop at 8:30 AM to Noon

Location:

Piedmont Chemical Industries

331 Burton Ave.

High Point, NC

NOTE: For security and safety reasons no cell phones or electronic equipment will be permitted in the building and everyone must have on closed toe shoes

Topics:

· Selling Safety to Management

· Starting a Safety Committee

· Maintaining an Effective Safety Committee

Speakers: Randy Cranfill, MESH, Safety Representative, NC Industrial Commission

Jim Gilreath, Safety Representative, NC Industrial Commission

Registration: Complete this form, save it on your PC. Email it as an attachment to Barbara Cassidy at: . Or fax the registration form to: 336-727-8045.

Name: Title:

Employer/Company:

Address: City: Zip:

Phone: Cell: Email:

Have you attended a CPSC workshop in the past? Yes: No:

Names of additional employees who will attend:

Name: Title:

Cost:

FREE to Individual and Business Members of CPSC

Business members may send multiple employees at no charge

Non-members may attend by paying the CPSC membership fee.

Please check one: Individual - $35: Business - $50:

Mail registration form and payment to: CPSC Treasurer, PO Box 2068, Jamestown, NC 27282

Directions: From WS or GSO, take Business 40 to Rt. 52 South. Merge onto I-40/US 311 via exit 107A. Merge onto US 311 via exit 196 to High Point. Take exit 25 toward N. Main St. Merge into US 311 South. Turn right onto Westchester Dr (NC-68). Go 3.6 miles and turn left on Burton Ave. Take the first right on Boyer, then next right on Ashford Circle and the Piedmont Chemical parking lot will be straight ahead. Someone at the gate will assist you with parking.

Note: Please remember, no cell phones or electronic equipment in this facility and wear closed toe shoes.

Sponsored by The Central Piedmont Safety Council – Founded in 1935

Serving the counties of Cabarrus, Davie, Davidson, Forsyth, Guilford, Iredell, Randolph, Rockingham, Rowan, Stanly, Stokes, Surry and Yadkin