Recognize Your Participation

Company Contact Person*

First Last

Email*

Company Name

Providing the company name is optional, but it helps the Alliance determine the reach and effectiveness of the Stand Up4Grain Safety Week, as well as gain insight into areas current outreach efforts may be missing.

Address

City State / Province / Region ZIP / Postal Code Country

This is optional. Consider providing the city and state so we can see how many places participated in the Stand Up for future planning purposes.

Tell Us Who Participated

How many facilities (locations) participated in your company's Stand Up 4 Grain Safety Week?

This is optional information. Companies with several locations and a central Stand Up coordinator may want to share how many of their locations participated.

How many people participated in the training event at your location?*

Was there a diverse group of participation?

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Managers/Supervisors
Workers
Contractors
Temporary Workers
Producers/Farmers

This is optional. It helps us understand who is participating in Stand Up 4 Grain Safety Week and how to better plan for the future.

Tell Us About Your Event

Help us understand what others are doing for Stand Up 4 Grain Safety Week and what your employees liked for future planning. This section is optional.

Type(s) of Event

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Demonstration / Presentation
Guest Speaker
Safety Topic Discussion
Training
Other

Please specify other event type(s).

How has participation in Stand Up Week impacted your company?

Stand Up Photos

Upload your Stand Up photos if you choose.

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Thanks for participating in Stand Up 4 Grain Safety Week!

Recognize Participation for 2021 Stand Up Week

Tell Us Who Participated

Tell Us About Your Event