ENTRY FORM

IMA-Europe 2016 Safety Award

“Good practices in injury prevention and health protection”

Criteria for: “Injury prevention & health protection”

The award will be given to the site/company/organisation for the best injury prevention and health protection programs that are innovative, proven effective and easily transferable. They are likely to involve the demonstration of strong and effective Leadership which, on its own, may be the subject of your entry.

Everything about training, communication, awareness, safety and health campaigns (including policies regarding near misses) will be welcome. Here are a few examples of what you might consider in your entry (this list is not exhaustive):

·  Training and coaching programs

·  Awareness programs, safety and health campaigns

·  Communication: Messaging, such as road shows, newsletters, briefings, use of technology, signage, working with contractors

·  Innovative inspection programs

·  Partnerships

·  Purchasing programs targeting safety and health aspects

Judges will be looking for your submissions to clearly define:

·  What you have done

·  Reasons for undertaking the initiative

·  The process you followed from concept to implementation

·  Who was actively involved

·  What was the outcome; Is the outcome measurable

·  What was particularly new or innovative or evolutionary

Preference will be given to entries which entail worker involvement, feedback to the workforce and demonstrable effectiveness. The good practices must have been implemented over the last 3 years (max.)

The IMA-Europe Safety Award supports the IMA Europe Target Zero Injury initiative launched in 2013 - for more information see http://www.ima-europe.eu/award/safety-award.


Company Name / IMA-Europe 2016 SAFETY AWARD
Open to all IMA-Europe members
Email this form, with photos + captions to:

Unit Name
(where entry is)
No. of Employees
Address for correspondence (including post code)
Contact for IMA-Europe / Name / Site Manager
(if different person from ‘Contact’) / Name
Email / Email
Mobile / Mobile
Entry Ref. No. / Shortly AFTER you submit your Entry, IMA-Europe will supply you with a
unique Reference Number, to be quoted in any further correspondence
Title of your Entry
(15 words max.)
Brief Description; and Benefits following introduction: (suggested maximum: 350 words)

Photographs: high quality images (‘before’ and ‘after’ photographs, if possible)

Attach photographs to your email that you send to IMA-Europe to accompany this entry.

Your email to include captions making it clear which caption belongs to which photo.

Please do not embed photos in a ‘Word’ document; image files ONLY (e.g. “.jpg”)

Submit your Entry / Attach this completed form and your photos to an email
Send to:

I give IMA-Europe the permission to use the pictures in future communications YES / NO

Comment:

Date:

Signature:

Industrial Minerals Association Europe aisbl, in short “IMA-Europe”

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Tel: 32 2 210 44 10, Fax: 32 2 210 44 29, E-mail: , www.ima-europe.eu