Order Free Safety Materials


1. Where should we mail your FREE safety materials?

Fields marked with an asterisk (*) are required.

First Name* Required.
Last Name* Required.
Title* Required.
Company* Required.
Mailing Address*
Required.
  Check if this is a home address.
City* Required.
State* Please select an item.
Zip* Required.
Phone* Required.
Email* Required.


2. Number of employees (including owner):
    0-5    6-10    11-20    21-50    51+   NA

 

3. Years company has been in business:
    0-5    6-10    11-20    21-50    51+

 

4. What is your primary business? (Check all that apply.)

 

 


 

5. How will you use these safety materials? (Check all that apply.)


 

6. What do you feel are the most important safety topics that need to be covered
    in training materials?

   

 

7. Is there another language that would be beneficial to have the materials in?
    

 

8. How much do you agree with each of the following statements?

  Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree
Ameren Illinois is committed to the safety of workers like me.
The information Ameren Illinois provides is valuable for keeping workers safe around electricity and natural gas.
I expect Ameren Illinois to provide workers the information necessary to get their jobs done safely around Ameren Illinois' electric and natural gas infrastructure.
The workers at my company use the Ameren Illinois safety information to work more safely around electricity and natural gas.
The worker materials provided by Ameren Illinois help me and/or my coworkers perform their jobs more safely.

 

 

 

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