CELL - Request More Information

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Community Engagement and Lifelong Learning Center (CELL)

CELL - Request More Information

Take the first step toward building a cooperative safety and health management system in your workplace.
Our services are totally confidential. For more information on our services or to request a free consultation, contact us via:

Email: safetyinparadise@uvi.edu

Phone:
St. Thomas (340) 693-1146
St. Croix (340) 713-1619

Locations:

St. Thomas                                                                         St. Croix

University of the Virgin Islands                                            UVICELL Center
Safety in Paradise - Faculty East                                         Joseph A. Simpson Building
#2 John Brewers Bay                                                         #23A Hospital Street, Fredriksted

Please fill out this form should you require additional information. Someone will get back to you shortly.

An asterisk (*) indicates a required field.

	Company Information
Company Name:
Company DBA:
Mailing Address:
City/State:
Zip:
Work Site Address:
Number of employees at site:	; in company:
Union?	Yes No
OSHA 300 Logs:	Yes No NA
Website URL:
Industry:
	Contact Information
Name *
Title/Position:
Email Address *
Phone *
Fax:
	Type of Assistance
	Identify the requested types of assistance below (choose from A or B, C and D. Check all that applies): A. Hazard Identification Limited (Survey limited to specific operation, equipment, or loss source not entire facility and job site): Health Safety Both
	B. Hazard Identification Full Service (complete hazard survey, technical program evaluation for the entire facility and job site): Health Safety Both
	C. Development of Safety and Health Program Comprehensive (development of company-wide safety policy) Limited (Limited to items associated with Hazard Survey in item A or B)
	D. Training & Assistance in: Health Safety Both
Did you receive a letter from OSHA?	Yes No
Is an OSHA inspection currently ongoing?	Yes No
	How did employer learn of the UVICELL Safety In Paradise Program? Direct Mail Web Word of Mouth Newspaper Radio Television Referral:
	Would you like to receive other information on UVICELL? Individual Training Corporate Training Consulting/Professional Services
Has the UVICELL Safety In Paradise Program made a previous visit to this establishment?	Yes No Don't Know
Comments or Additional Information: