Membership Application

Apply today - it takes only a few minutes.

Use this form to place your Membership Registration. Your credit card is processed by PayPal after you complete this form or you can issue a purchase order. You will receive an email confirm your registration. Passwords should be at least 6-15 characters long. Should include at least one (1) number, one (1) character, no puncutation marks or spaces. Items with an  must filled out.

In an effort to reduce the number of workplace accidents and to share resources and information on accident prevention, risk management and workers’ compensation in Ohio, the BWC’s Division of Safety & Hygiene and your local safety council co-sponsor this program.

In signing this enrollment form, the employer makes a commitment to send representatives to the majority of safety council meetings and to submit semi-annual reports by the deadline dates.

All credit card transactions are processed on PayPal's SSL secure website. You are not required to have a PayPal account to pay your membership through PayPal.

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Lake County Safety Council
6972 Spinach Drive, Mentor, OH 44060
440.255.1616
440.255.1717
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