Health, Safety & Wellbeing - Gov.uk

Health, Safety & Wellbeing Awards 2017: Entry form BEFORE YOU START: Download this PDF to your desktop. Then complete the form and save your changes before emailing. Closing date for submissions: 15th December at 5pm Awards category Select a category

Title of submission Give your submission a title and once complete, save the file as follows: name_title of submission_category

Supplier name or Highways England employee/team name

Please provide contact details for your communications/media team for publicity purposes if not a Highways England employee:

Name and job title Telephone

Email

Tier 1 yes

Tier 2 no

yes

Tier 3 no

yes

no

Company name and address:

Contact name and position:

Telephone

For joint submissions please confirm the above company is the main point of contact

yes

no

Are you prepared for extracts from your submission to be used in any best practice we choose to use/share?

yes

no

Executive summary Provide a short summary / bullet points of the submissions key points (max 150 words)

Email

Submission (Page 1)

Submission (Page 2)

Submission (Page 3)

Submission (Page 4)

Submission (Page 5)

Submission (Page 6)

Your submission should be no more than the 6 pages supplied set as Arial 11pt font. Any additional annex/documents will not be judged. Please attach a copy of your logo plus two photos relating to your submission and email along with your submission to: [email protected] Checklist: � Completed form / submission � A copy of your company logo � Two photos relating to the submission

Highways England Creative BHM17_0287_PJW