Note:

Good Practice Awards Competition2016-17

APPLICATION FORM –Ireland

To be completed and signed byapplicant

Electronic entries only. Please email osing Date: Friday 30thSeptember 2016 at5pm

EXAMPLE OF GOODPRACTICE
TOPIC
TITLE OFEXAMPLE
NAME OFTHEENTERPRISE
NUMBER OFWORKERS
Country
Address
TelephoneNo
FaxNo
Name of acontactpersonrepresentingthemanagement
Email
Name of acontactpersonrepresentingtheworkers
Email
ORGANISATIONPROVIDINGTHEINFORMATION(if
different fromabove)
Country
Address
TelephoneNo
FaxNo
Email

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Contactperson
SECTOR(NACE-Code)
Private / public /partiallyprivate
BACKGROUNDINFORMATION
PROBLEM / ISSUESIDENTIFIED
SOLUTION / INTERVENTION / MEASURES TAKEN / WHAT WAS DONE ANDHOW
RESULTS ACHIEVED/ EFFECTIVENESS OF THEMEASURES
SUCCESSFACTORS
COSTS/BENEFITS
(including human,social,and economic costsandbenefits)
ADDITIONAL INFORMATION: PLEASE ATTACH A LIST OF ANNEXES /ADDITIONALINFORMATION
WITHSHORTDESCRIPTIONS(e.g.photosand/orotherillustrationsofthegoodpracticeexample,training materials,etc.)
PLEASE INDICATEWHOSHOULD GET THEAWARD / TheenterpriseThe provider ofinformationOthers

IhavereadthetermsoftheprivacypolicyofEU-OSHAandIagreetotheprocessingofmypersonaldata.

IholdtherightsonthesubmittedphotographsandIagreethattheycanbeusedbyEU-OSHAintheframeworkof the Good Practice Awards procedure and publications as well as that the photographs can be stored intheEU-OSHA Digital Image Library and used for further non-commercial promotion of occupational safetyandhealth.

Date and signature of the representative of theorganisation

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Explanation of terms used in the applicationform:

  • TOPIC – A few key words / sentences to describe theexample.
  • TITLE OF THE example: One line, e.g. Introducing comprehensive age management, Implementingagesensitive risk assessment, Interventions to prevent early retirement,etc.
  • NAME OF THE ENTERPRISE / ORGANISATION PROVIDING THE INFORMATION: occasionallytheorganisation submitting the case is different from the enterprise where the good practice was carried out. Inthiscase, please provide details of both organisations and details of the contacts in bothorganisations.
  • SECTOR: The sector (a four digit number) should be indicated by using the Statistical Classification ofEconomicActivityintheEuropeanUnion,NACERev.2,2008,
  • Private or public: Is this a private or publicenterprise?
  • BACKGROUND INFORMATION: description of the company / workplace / activity / situation givingriseconcerns.
  • PROBLEM/ISSUEIDENTIFIED:descriptionofhow,whenandinwhatformhazards/risksarise,andoftheeffectsandoutcomes(anyillhealth,diseases,accidents,effectsonproductionandworketc.)ThedescriptionneedstobeclearsothatthoseaccessingtheinformationviatheInternetcanunderstandthestepstakenandwhy.
  • SOLUTION / INTERVENTION / MEASURES TAKEN / WHAT WAS DONE AND HOW: a clear description ofthemeasures taken, e.g. development of policies / interventions, involvement of the workforce, implementationetc.It should be easy to understand and the reader should get a clear picture of the intervention / of what wasdoneand how.
  • COSTS / BENEFITS: an indication of the costs accrued during the implementation of the measures andthereduction of costs as a direct or indirect consequence of the innovation (whereavailable).
  • RESULTSACHIEVED/EFFECTIVENESSOFTHEMEASURES:anindicationofthemeasurableresults(e.g.reduced sickness absence), and also of any “immeasurable” benefits (better workplace climate). This caninclude human, social, and economic costs, benefits, and positiveoutcomes.
  • SUCCESS FACTORS: elements essential for achieving the desired outcome, e.g. workersinvolvement,management commitment, cooperation of HR and OSH management,etc.
  • PHOTOS AND ANY OTHER ILLUSTRATIVE MATERIALS should be provided as additional informationwherepossible including graphs, tables andcharts.

Privacy policy for the submission of the Healthy Workplaces Good Practice Awardapplication:

Thedatarequestedonthisformissolelyforthepurposeofselectingenterprisesforthe2016-17HealthyWorkplacesGood Practice Awards (GPA), and then for displaying the 2016-17 GPA awarded and commended enterprises data on theHealthy WorkplacesCampaignwebsiteandEU-OSHACorporatewebsite,aswellastopublishexamplesofawardedandcommended enterprisesinthe2016-17GPAbookletwhichwillbeavailableontheHealthyWorkplacesCampaignandEU-OSHACorporate website and printed fordissemination.

DatawillbetransferredtothenationalFocalPointsandalsotoexternaljurymemberswhoarepartoftheGPAjuryappointedby EU-OSHAtobeabletoevaluatetheGPAcases.Moreover,datawillbetransferredtothirdpartypartners/contractorswhowill managedifferentcommunicationsrelatedtocampaignactivitiesonbehalfofEU-OSHA,includingcommunicationoftheaward decision, newsletters, news, invitations to events orsurveys.

The data displayed on the websites and publicationsinclude:

  • Name and address of theenterprise
  • Website of theenterprise
  • Issues addressed by the casestudy/example
  • Description of the casestudy/example

Data related to the winning and commended enterprises, is kept in the EU-OSHA Corporatewebsite. The data collected through the GPA formsincludes:

  • Company / Organisationname
  • Number ofworkers
  • Address
  • General emailaddress
  • General telephonenumber
  • General faxnumber
  • Name of a contact person representing themanagement
  • Email

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  • Name of a contact person representing theworkers
  • Email
  • Organisation providing theinformation
  • Address
  • Telephone no
  • Faxno.
  • Email
  • Contactperson
  • Sector(NACE-Code)
  • Private / public / partiallyprivate
  • Title and issue(s)addressed
  • Task
  • Problem (hazard/risk/outcome)
  • Solution (prevention measure(s)taken)
  • Effectiveness of results
  • Success factor/s
  • Costs/benefits
  • (including human, social, and economic costs andbenefits)
  • Photos and/or other illustrations of the good practice example,pictures.
  • Who should get theaward

Thedataincludedintheabove-mentionedformistobesentbyyou,viaemailorpost,toyourNationalFocalPoint.TheFocal Points will select the most suitable candidates from each country, and send their data to EU-OSHA GPA Committee.By submitting this form, you agree EU-OSHA to transfer your data to third party contractors/partners managingdifferent communications about the award decision, on behalf of EU-OSHA, and to display your data on the HealthyWorkplaces Campaignwebsite,EU-OSHACorporatewebsiteandGPAbooklet,andcompromisetokeepEU-OSHAinformedwithchanges and updates for the duration of thecampaign.

Who can access yourdata?

Accesstothepersonaldataisgrantedonthebasisoftheroleandresponsibilitiesofthesubjectsinvolved(“needtoknow” principle):

  • National Focal Points’staff
  • Duly appointed EU-OSHA staff to the Healthy Workplaces Campaignproject
  • External members of the GPA jury appointed byEU-OSHA
  • External provider hosting and maintaining EU-OSHA’sserver
  • Legal Service, Civil Service Tribunal, the European Data Protection Supervisor, the European Anti-Fraud Office(OLAF), the European Ombudsman, the Court of Auditors, the Internal Audit Service, ifapplicable.

All the recipients mentioned are bound by Regulation (EC) Nº 45/2001 of the European Parliament and of the Council of18 December2000ontheprotectionofindividualswithregardtotheprocessingofpersonaldatabytheCommunityinstitutionsand bodiesandonthefreemovementofsuchdata.Theymightbebound,aswell,bythetranspositionofthisdirectiveintothe respective national laws on dataprotection.

EU-OSHAwillnotdisclosepersonaldatatothirdpartieswithouttheirspecificrequestorunambiguousconsent.EU-OSHAwillnot divulge personal data for direct marketing for commercialpurposes.

Yourrights

HealthyWorkplacesGoodPracticeAwardscandidatescanaccesstheirpersonalinformation,verifyitsaccuracy,deleteitand correctitbyloggingintothesystem.However,ifyouhaveanyquestionsabouttheHealthyWorkplacesCampaign2016-17, which are not addressed here or in the public section of the official campaign website, please contact usat: .

Wetakeappropriatesecuritymeasurestoprotectagainstunauthorisedaccesstoorunauthorisedalteration,disclosureor destruction of data. These include internal reviews of our data collection, storage and processing practices andsecurity measures,includingappropriateencryptionofcommunicationandphysicalsecuritymeasurestoguardagainstunauthorised access to systems where we store personaldata.

Shouldyouhavequeriesorcomplaintsregardingthecollecting,processingoruseofyourpersonaldata,pleasecontacttheData Protection Officer at . In case of conflict, complaints can also be addressed to the EuropeanDataProtectionSupervisor.

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