Due Diligence Questionnaire - Membership

This questionnaire has been issued by the American society for occupational safety and health  for completion by (Agents).
Its purpose is to get an understanding of how your company is structured, its existing policies, practices, and procedures, identify areas of weakness and risk regarding bribery and corruption.
The information provided will only be used for that purpose and will not be used for any other purpose. The information provided will be securely retained and will be destroyed if the Agents are not appointed

Membership Questionnaire

1. COMPANY INFORMATION

Address
Address
City
State/Province
Zip/Postal
Type of Business
Which of these membership categories do you want
Which of these, best describes where your business operates?

2. OWNERSHIP INFORMATION

Please provide the details of all Company Directors and their ownership interest. If the ownership interest is ‘0’, please insert N/A in the box provided.

3. CONTACT INFORMATION

Please list all officers or employees of your company that are authorised to act on your company’s behalf. Evidence required: Letter on company headed paper.

4. FINANCE INFORMATION

We do not accept third party payments. To verify this will not occur, please provide payment details as follows.

5. Documents Required

Please tick below to confirm you have included a copy of the below documents alongside your application form.
Maximum upload size: 33.55MB
Maximum upload size: 33.55MB

Declaration

I hereby certify that the information provided above and in any attached sheets of paper is to the best of my knowledge and belief, accurate, current and complete.

Individual Membership

Information

Title
Please enter First Name, Middle Name or Initial, Surname/Last Name, and Suffix (if applicable).
Birthdate is required for identification purposes. ASOSH will NEVER share your birthdate.
Membership
Address
Address
City
State/Province
Zip/Postal
Country
Area(s) of Professional Expertise
Maximum upload size: 25MB