FY '25/'26 Ohio Trucking Safety Council Enrollment Form

BWC’s Division of Safety & Hygiene co-sponsors safety councils to provide Ohio employers with access to occupational safety and health, workers’ compensation and risk management education, networking, and resource sharing.

In completing this enrollment form, the employer makes a commitment to send representatives to monthly Ohio Trucking Safety Council meetings.

The enrollment deadline for FY '25/'26 is July 31, 2025.

You do NOT need to complete this form if you are currently enrolled in the Ohio Trucking Safety Council program. You will automatically be re-enrolled in the program for FY '25/'26.

Fields marked with an * are required.

Enrollment Date *

Employer Name *

Physical Address *

City *

State *

Zip Code *

Phone Number *

Email *

BWC Policy Number *

Name of Person Submitting Application *

Title of Person Submitting Application *

By checking this box, I am authorizing enrollment into the Ohio Safety Council program. *

FY '25/'26 Ohio Trucking Safety Council Enrollment Form

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