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* 1. What is your full name?

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* 2. What is the name of your organisation/company/business?

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* 3. Which of the following best describes your role in industry:

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* 4. In which state/s does your business operate?

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* 5. Which specific area of safety optimisation does your initiative address? Please select all that apply:

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* 6. Describe your safety initiative and what safety issue/s it targets. Why did you choose to implement this initiative? What barriers did you have to overcome to incorporate this initiative within your organsiation/business?

Response Guidance & Considerations: Examples of critical safety issues may include hazards related to the following; vehicles, equipment/machinery, biological agencies, muscular stress, heat exhaustion, mental health etc.

Judging Criteria:
The initiative clearly links to a safety issue (0-5)
Address a prevalent and/or critical concern within the sector (0-5)

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* 7. How has your initiative contributed to meaningful safety improvement from within your organisation/business?

Response Guidance & Considerations: Reliability of data, degree of impact and outcomes, contribution to sustained improvements (e.g. reduced near misses), employee engagement and useability, accountability and standards setting etc.

Judging Criteria: Provides quantifiable evidence that showcases a reduction in near misses and/or injuries. (0-5)
Provides secondary evidence (photo/video footage/employee testimonials) that showcases the initiative working in action. (0-5)

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* 8. How is your organisation/business committing to ongoing success in workplace health and safety best practice?

Response Guidance & Considerations: Onboarding and investment in training and upskilling, effective management structure and WHS systems for monitoring and recording, building a workplace safety culture, empowering workers to participate in workplace safety in a manner that isn’t onerous or burdensome, committing to long-term investments to improve workplace health and safety best practice.

Judging Criteria: Demonstrates a substantial investment in enhancing safety measures (beyond legislated requirements) now and in the future. (0-5) Has incorporated measures to embed workplace health and safety excellence throughout their operations. (0-5)

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* 9. How will this initiative benefit the wider sector? What barriers and opportunities do you foresee in organisations within the sector incorporating this safety initiative/s within their own operations? How might this be overcome and how could successful outcomes be supported?

Response Guidance & Considerations: Provides an adaptable and easy to implement system, reduces occurrence of critical safety issue, valuable case study/blueprint for industry. Financial barriers, training and education needs, administration/record keeping, staff engagement. Incentives, community engagement, awareness campaigns, utlising digital tools to promote efficiency etc.

Judging Criteria: There are clear benefits of this initiative to the wider sector. (0-5)
There are clear opportunities to support widespread incorporation and overcome barriers to facilitate successful implementation. (0-5)

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* 10. Please confirm the following:

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* 11. Please provide your email address:

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* 12. Please provide your contact number:

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* 13. Please attach your evidence of your initiative here:

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