Name *
Title
Organization *
Department
Address1
Address2
City
Province/State
E-Mail *
Country *	Select a country.... CANADA USA AFGHANISTAN ALBANIA ALGERIA ANDORRA ANGOLA ANTIGUA AND BARBUDA; ARGENTINA ARMENIA AUSTRALIA AUSTRIA AZERBAIJAN BAHAMAS BAHRAIN BANGLADESH BARBADOS BELARUS BELGIUM BELIZE BENIN BHUTAN BOLIVIA BOSNIA AND HERZEGOVINA BOTSWANA BRAZIL BRUNEI DARUSSALAM BULGARIA BURKINA FASO BURUNDI CAMBODIA CAMEROON CAPE VERDE CENTRAL AFRICAN REPUBLIC CHAD CHILE CHINA COLOMBIA COMOROA CONGO CONGO-DR COSTA RICA COTE D'IVOIRE CROATIA CUBA CYPRUS CZECH REPUBLIC DENMARK DJIBOUTI DOMINICA DOMINICAN REPUBLIC ECUADOR EGYPT EL SALVADOR EQUATORIAL GUINEA ERITREA ESTONIA ETHIOPIA FIJI FINLAND FRANCE GABON GAMBIA GEORGIA GERMANY GHANA GREECE GRENADA GUATEMALA GUINEA GUINEA-BISSAU GUYANA HAITI HONDURAS HUNGARY ICELAND INDIA INDONESIA IRAN IRAQ IRELAND ISRAEL ITALY JAMAICA JAPAN JORDAN KAZAKHSTAN KENYA KOREA-DPR KUWAIT KYRGYZSTAN LATVIA LEBANON LESOTHO LIBERIA LIECHTENSTEIN LITHUANIA LUXEMBOURG MADAGASCAR MALAWI MALAYSIA MALDIVES MALI MALTA MARSHALL ISLANDS MAURITANIA MAURITIUS MEXICO MICRONESIA MONACO MONGOLIA MOROCCO MOZAMBIQUE MYANMAR NAMIBIA NEPAL NETHERLANDS NEW ZEALAND NICARAGUA NIGER NIGERIA NORWAY OMAN PAKISTAN PALAU PANAMA PAPUA NEW GUINEA PARAGUAY PERU PHILIPPINES POLAND PORTUGAL QATAR REPUBLIC OF KOREA REPUBLIC OF MOLDOVA ROMANIA RUSSIAN FEDERATION RWANDA SAINT KITTS AND NEVIS SAINT LUCIA SAMOA SAN MARINO SAO TOME AND PRINCIPE SAUDI ARABIA SENEGAL SEYCHELLES SIERRA LEONE SINGAPORE SLOVAKIA SLOVENIA SOLOMON ISLANDS SOMALIA SOUTH AFRICA SPAIN SRI LANKA SUDAN SURINAME SWAZILAND SWEDEN SYRIAN ARAB REPUBLIC TAJIKISTAN TANZANIA-UR THAILAND TOGO TRINIDAD AND TOBAGO TUNISIA TURKEY TURKMENISTAN UGANDA UKRAINE UNITED KINGDOM URUGUAY UZBEKISTAN VANUATU VENEZUELA VIET NAME YEMEN YUGOSLAVIA ZAMBIA ZIMBABWE
Mailing Code
Phone
(Area Code) (Number) ext.
Fax
(Area Code) (Number)

Your job type is best described as:
Regulatory Occupational Hygiene Chemistry/Science/Research Engineering/Production/Operations	Management/Administration Safety/Security/Fire/Emergency Medical Library

Your department type is best described as:
Goods Production
Primary Resources, Oil and Gas, Mining, Agriculture Chemicals, Pharmaceuticals, Plastics	Food, Textile, Wood, Paper, Rubber, Stone, Glass Metals, Machinery, Electronics, Other Industries

Services
Transportation and Public Utilities Wholesale and Retail Businesses	Consultants and Legal Services Other (eg. Finance, Insurance, Food, Hotel)

Educational
University, College School/School Board	Public Libraries, Museums and Archives

Health and Social
Hospitals Health Clinics and Medical Agencies	Public Health Departments Other Health Services

Government
Federal Departments, Federal Agencies Provincial and Territorial Departments and Corporations	Municipal, Regional Departments Fire and Emergency Services

Other
Do you currently purchase CCOHS products or services? No Yes

How did you locate the CCOHS Website? Please specify source(s). Select all that apply.

Link from other site		Journal
Newspaper		Internet Search Engine
Directory

Other (Please specify)

If you would like to receive more information about CCOHS' Products and Services, please let us know by checking the items from the list below.

ACGIH Industrial Ventilation Manual		IPCS INCHEM
Canadian enviroOSH Legislation Series - National		IPCS INTOX
Canadian enviroOSH Legislation Series - Ontario		MSDS
Canadian enviroOSH Legislation Series - Western		NIOSH Manual of Analytical Methods
Canadian enviroOSH Legislation Series - Eastern		NIOSHTIC®
Canadian enviroOSH Legislation Series - Plus Standards		OSH CanData
The Chemical Advisor®		OSH InterData
CHEMpendium™		RTECS®
FTSS		TOXLINE®
HRDC Labour Branch (Operations)		TOXLINE®

Publications - Health & Safety Guides

		Cold Weather Workers Safety Guide			Violence in the Workplace Prevention Guide
		Food Service Workers Safety Guide			Warehouse Workers Safety Guide
		Groundskeepers Safety Guide			Welders Health and Safety Guide
		Health & Safety Committees Reference Guide			Influencing Attitudes Toward Workplace Illnesses & Injuries
		Indoor Air Quality Health & Safety Guide			OSH Answergrams
		Noise Control in Industry: A Basic Guide			Safety Infograms
		Office Ergonomics Safety Guide			Understanding an MSDS
		School Workers Health and Safety Guide

Please feel free to post any comments to CCOHS.