Alliance -- An OSHA Cooperative Program<< Back to Annual Report on the Alliance Program




Date:

Alliance: Alliance Coordinator:

1. Product name (if known):_____________________________________________

2. Product type:

    Electronic Assistance Tools
  • eTool
  • Safety and Health Topics Page
  • Other ____________________
  • Printed Material
  • Fact sheet
  • Tip sheet
  • Brochure
  • Manual
  • Other ____________________

3. Product ownership:

  • OSHA
  • Alliance Program Participant


4. Target audience:

  • Employees
  • Employers
  • OSHA staff
  • Other _____________________

5. Describe product (e.g., reason for developing product, hazards addressed, how product will be used):





6. Describe the resources needed to develop this product:





7. Describe the resources that the Alliance Program participant will provide for the development of this product:




8. Alliance Program participant point of contact for this product:

Name: ________________________ Phone: _______________________ Email: __________________________