In order to assist us in providing you with the best service for your business, please complete the following information sheet. The information is used solely by WHSS to assist in addressing your specific concerns. By completing the electronic form, you will automatically receive our newsletter, published six times per year. The newsletter is designed to keep your business up to date on current issues affecting the business community in the environmental health and safety area.

Business Name:
Contact Name:
Phone:	ext.
Email:
Address:
Type of Industry:	Education Manufacturing Service/RetailConstructionHealth CareOther
Number of Employees:	1 - 5   6 - 19  20+
Union:	Yes: No:
Do you have a Joint Health and Safety Committee?	Yes:  No:
Health and Safety Issues you would like us to help you with:
If you prefer, please call 613-546-9814 or email us at info@whss.ca.