Alliance Ambassador Document Template


OSHA’s Alliance Program provides the following agreement template to assist organizations preparing an initial, national Alliance agreement. Under the Paperwork Reduction Act, a Federal agency generally cannot conduct or sponsor, and the public is generally not required to respond to, an information collection, unless it is approved by OMB and displays a valid OMB Control Number. Use of this template is voluntary. The template ensures that Alliance participants provide required information about potential Alliance activities to OSHA. OSHA estimates employer burden for the completion of this collection of information ranges from 6 to 10 hours, with an average of 8 hours. This estimate includes the time for reviewing instructions, determining goals, and developing objectives for the agreement. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to or to OSHA’s Directorate of Cooperative and State Programs, Office of Outreach Services and Alliances, Department of Labor, Room N-3662, 200 Constitution Ave., NW, Washington, DC 20210; Attn: Paperwork Reduction Act Comment. 1218-0274 (This address is for comments regarding this form only; DO NOT SEND ANY COMPLETED TEMPLATES TO THIS OFFICE IN THIS MANNER.)

OMB Approval # 1218-0274; Expires: 03/31/2026

<SPECIFY OFFICE(S) if preparing a Regional and/or Area Office document>

Since entering into an Alliance on <initial date>, with subsequent renewal(s) on <date(s)>, the U.S. Department of Labor’s Occupational Safety and Health Administration (OSHA) <Specify Office(s) if preparing a Regional and/or Area Office document> and <Organization Name(s)> have worked together to improve workplace health and safety by sharing information, guidance, and access to training resources that address occupational hazards, and promoting understanding of the rights of workers and the responsibilities of employers under the Occupational Safety and Health Act.  

OSHA and <Organization Name(s)> continue to recognize the value of maintaining a collaborative relationship to improve safety and health practices and programs in American workplaces, and commit to continue their work together through an Alliance Program Ambassador relationship.  

In recognition of this ongoing commitment, OSHA will continue to foster an active relationship with <Organization Name(s)> by:

  • Providing routine communications on enforcement, regulatory, and outreach initiatives.
  • Sharing invitations to and offering opportunities to speak at OSHA Alliance Program and other agency stakeholder meetings or events, such as outreach and training activities through the National, Regional, or Area Office, and the National Alliance Program Construction Roundtable and Forum.
  • Engaging in information sharing and technical discussions, as appropriate, including completing special projects of mutual interest that align with agency priorities and as resources allow.
  • Maintaining the organization’s <or organizations’> status as Alliance Program Ambassador<s> on the agency’s public webpage.

<Organization Name(s)> will continue to foster an active relationship with OSHA by:

  • Sharing information with members and stakeholders on OSHA’s National Initiatives (Enforcement, Regulatory, and Outreach), and encouraging their participation in OSHA’s outreach initiatives and rulemaking processes.
  • Sharing information with members and stakeholders on occupational safety and health laws and standards, including the rights and responsibilities of workers and employers.
  • Encouraging <Organization Name(s)> chapters/worksites to build relationships with OSHA’s National, Regional and Area Offices to address health and safety issues.
  • Sharing information with OSHA personnel and industry safety and health professionals regarding < Organization (Name(s)> good practices or effective approaches through training programs, workshops, seminars, and lectures (or any other applicable forum).
  • Offering OSHA opportunities to speak, exhibit, or appear at one another’s conferences, local meetings, or other <specify> events.
  • Adhering to requirements laid out in the Alliance Program Directive regarding the prohibition on promoting or implying the agency’s endorsement of their policies, products, or services, including acknowledging that they will not receive any preferential treatment related to any statutory function of the agency.
  • Abiding by all terms and conditions for the use of the Alliance Program logo as specified in OSHA’s Guidelines for Use of the Alliance Logo

OSHA’s cooperative programs provide organizations an opportunity to participate in a voluntary, collaborative relationship with OSHA for purposes such as raising awareness of OSHA’s initiatives, outreach, communication, training, and education. These programs have proven to be valuable tools for both OSHA and participants. By entering into this Ambassador relationship, OSHA is not endorsing or promoting, nor does it intend to endorse or promote, any of that organization’s products or services.

This Ambassador relationship will remain in effect for the duration of an ongoing cooperative association and a good faith effort by <specify: both/all> parties to meet the intent of this document and its underlying policies. <specify: Either/Any> signatory may terminate it for any reason at any time, provided they give 30 days’ written notice. <If Ambassador document will have multiple signatories, include this sentence: Termination by one signatory will not nullify the Ambassador relationship with all signatories, with the exception of OSHA; OSHA may terminate the Ambassador relationship as a whole, or its relationship with one or more individual signatories.>

Signed this <date> day of <month>, <year>.



Occupational Safety and Health Administration

<Organization Name>