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“Your safety is OUR business”
St. Joseph Safety & Health Council
"Your Safety is Our Business"
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2024 Occupational Membership Registration Form
Company Name
*
Mailing Address
*
City
*
State
*
Zip
*
Phone
*
(###)
###
####
Briefly describe your company/business.
Contact Information
Primary Safety and Health Contact
*
First Name
Last Name
Title
Email
*
Phone
(###)
###
####
Additional Contact
First Name
Last Name
Title
Email
Phone
(###)
###
####
2024 Membership Information
Number of employees at your facility.
*
(Please be specific)
Select appropriate fee based on the number of employees stated above.
*
Please contact the Safety Council at 816-233-3330 if you are unsure if your company is outside the Metro Area.
1-9 Employees: $180
10-19 Employees $280
20-49 Employees $305
50-99 Employees $355
100-199 Employees $380
200-499 Employees $430
500+ Employees $490
Companies Outside Metro Area $255
United Way Non-profits $230
Payment Options
*
Check mailed to: 3131 Frederick Ave. St. Joseph, MO 64506
Credit Card (once this form is submitted, you will be routed to an online payment screen)
Send invoice to:
address or email to send invoice to:
Please submit any comments or spacial requirements regarding your company's membership.
By submitting this form, you understand that becomming a member of the St. Joseph Safety and Health Council imposes no specific obligation on your company/business other than the annual payment as indicated.
Thank you!
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