Region IX VPPPA Mentor Request

The VPPPA Mentoring Program is a formal process to assist companies/facilities interested in the VPP and improving their safety and health management systems. The program matches interested sites in Region IX with current VPP Star sites to help them achieve VPP recognition. Region IX VPPPA utilizes our regional network to establish a mentoring relationship. Depending on a site's preferences and needs, state coordinators consider similar experiences, industries, geographic location and union representation when choosing identifying mentors.

Once a match has been made, the sites form a unique relationship based on the needs of the mentored site and the time and resources available to the mentor.

The VPPPA Mentoring Program is a free resource provided by the association to sites regardless of membership status.  Joining the VPPPA as an associate or full member is an added benefit to all involved and is highly encouraged.

To request a mentor, please complete the survey.  A representative from either a mentor site or the VPPPA will contact you shortly. 

Company / Worksite Name 

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* 1. Company / Worksite Name 

Address (street, city, state, zip)

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* 2. Address (street, city, state, zip)

Contact name and title

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* 3. Contact name and title

Contact email and phone number

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* 4. Contact email and phone number

Brief description of industry

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* 5. Brief description of industry

Number of employees at worksite

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* 6. Number of employees at worksite

VPPPA Membership status

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* 7. VPPPA Membership status

Knowledge level of the VPP

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* 8. Knowledge level of the VPP

Additional information about the worksite

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* 9. Additional information about the worksite

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