Order Free Safety Materials

1. Where should we send your FREE safety materials?

First Name* Required
Last Name * Required
Title* Required
Company* Required
Mailing Address*
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  Check if this is a home address.
City* Required.
State* Please select an item.
Zip* Required.
Phone * Required.
Email* Required.


2. Number of employees (including owner):
    0-5    6-10    11-20    21-50    51+   NA

 

3. What is your primary business? (Check all that apply.)


 

4. How will you use these safety materials? (Check all that apply.)


5. What do you feel are the most important safety topics that need to be covered
    in training materials?
   

 

6. How much do you agree with each of the following statements?

 

Strongly agree

Agree

Neither agree nor disagree

Disagree

Strongly disagree

Evergy Inc. is committed to the safety of workers like me.

The information Evergy Inc. provides is valuable for keeping workers safe around electricity.

I expect Evergy Inc. to provide workers the information necessary to get their jobs done safely around Evergy Inc.’ electric infrastructure.

The workers at my company use the Evergy Inc. safety information to work more safely around electricity.

The worker materials provided by Evergy Inc. help me and/or my coworkers perform their jobs more safely.

 

7. Years company has been in business:
    0-5    6-10    11-20    21-50    51+

 

8. Is there another language that would be beneficial to have the materials in?
    

 

 

 

Internal Use Only

ID

BRC Code

Date (mm/dd/yy)