Subscription Form

Free small and medium sized business workshops

Managing for Safety – Getting started

Please fill in the form below to register your attendance.

Your personal details are held securely and will not be passed on to any other group or agency. For more information please refer to our privacy policy.

Title

First name*

Last name*

Job title

Company name

Phone number*

Email address*

How did you find out about this workshop?

	Workplace Health and Safety Queensland		Your employer/colleagues
	Industry association		Other government agency
	Word-of-mouth		Received an e-mail
	Read about it in a newsletter/newspaper		Internet (e.g. Google search or website link)
	Don't remember

Other: (please specify)

Location

Day

Date

Time

Venue1

Building

Streetaddress

Suburb

Workshop type

Subscribe to eNEWS, a free email subscription service, keeping you informed on the latest health and safety issues that affect workplaces in Queensland

Yes

Workplace Health and Safety Queensland
Department of Justice and Attorney-General
Level 3, 75 William Street
Brisbane, Queensland 4000 Australia
Telephone 1300 369 915
Website www.worksafe.qld.gov.au