Case Study   BACK		NATE Case Study Application Does you company have a great story to share about safety? Would you like that story showcased to NATE members and the public? If so, don't miss this chance to submit your company as a NATE case study example; it's a great opportunity to promote positive safety programs within your company. Case studies are the perfect way to endorse your company's accomplishments and receive public recognition for your commitment to safety! Your company's story could be featured in various public relations efforts, such as media articles, trade show speeches and possible interviews for NATE companies to show NATE's commitment and dedication to safety. The case studies paint a vivid picture of your company's safety efforts and accomplishments and help tell NATE's story. To submit your company as a NATE case study participant, simply fill out the application below and click the submit button at the bottom of the application. Once your application is reviewed, you will be contacted for a short interview by GolinHarris, NATE's public relations team, to learn more about your company's safety initiatives. Don't let this opportunity pass you by! Share your case study stories today! *Company* *Contact Name* *Telephone number* *NATE Member Since:* *Number of Employees* *Number of Years in Business* *Experience Mod Factor: *Select one:  Less than 1.0  1.0 - 1.25  1.26 - 2.0  Higher than 2.0 *1. What percentage of your employees have completed the folowing levels of training? Tower related OSHA 10-hour Training (for all personnel working on a tower site) OSHA 30-hour Training (for anyone operating in a supervisory capacity) *2. Do you maintain records of employee training? *Select one:  Yes  No *3. Does your company have a safety and health program in place that meets the standard established by the NATE Accident Prevention, Safety and Health Program Guide? *Select one:  Yes  No *4. How often do you conduct safety audits? *Select one:  Once a month  Once every quarter  Once a year  Twice a year *5. Does your company have a dedicated Safety Manager? *Select one:  Yes  No 6. How long has he or she been in place? 7. How many years of experience does he or she have? *8. Do you provide a site-specific safety plan for each job? *Select one:  Yes  No *9. What requirements does this plan include? Rigging Structural RF safety procedures? Fall protection requirements? *10. Do you require pre-employment physical agility or physical fitness tests to determine employee's ability to perform job tasks? *Select one:  Yes  No *11. How often do you conduct drug screening of your employees? Select one:  Once a month  Twice a year  Once a year  Never *12. How often do you conduct a hazard assessment to determine the requirements for personal protective equipment, including fall protection? *Select one:  Once a month  Twice a year  Once a year  Never *13. What are your requirements for hiring subcontractors? *14. Does your company adhere to the provisions of OSHA Directive CPL 2-1.36 if any personnel hoisting is to be conducted? *Select one:  Yes  No *15. Does your site use a lockout/tagout program? *Select one:  Yes  No *16. Explain briefly how safety is a regular part of your company's operation. Thank you for completing the case study. Before submitting your case study, we suggest printing a copy for your records.
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