2025 STS Panel Invitation Form

2025 STS Panel Invitation Form

Self-Assessment Writing

Please indicate your interest by completing the fields with a red asterisk and submitting the form at your earliest convenience but not later than Sunday, August 31, 2025

STS Self-Assessment Writing Activity*

(In-Person Meeting in Indianapolis)

November 10-12, Monday-Wednesday

8:00 a.m. to 5:00 p.m. (Eastern Time) Monday-Tuesday

8:00 a.m. to 2:30 p.m. (Eastern Time) Wednesday

General Information

Date Submitted*

Prefix*

Select

First Name*

Preferred First Name

If different from legal first name

Last Name*

Email*

Mobile Phone Number*

Certification Information

(Please go to https://www.bcsp.org/>My Profile>Certification History to view your specific information for this category)

Date Certified*

Additional BCSP Certifications Held*

Select

Customer ID

Enter your 10-digit Customer ID number here (found under your name on the left side of the page... ex. 100XXXXXXX)

Previous BCSP Panel(s)*

Located in Category 5 of recertification worksheets. If none, please indicate with N/A

Demographic Information

City*

State*

Select

Region*

Select

Country*

Select

Gender*

Select

Age*

Select

Race*

Select

Ethnicity*

Select

Highest Academic Degree Achieved*

Select

Employment Information

Industry*

Select

Employer*

Job Title*

International Experience

International Work Experience*

(Do you have any work experience outside the US?)

Select

List country/countries*

Select

Resume Upload

Drag and drop files here or

Share Your Safety Stories With Us!

Whether it's a personal story of how you became involved with the safety profession or a proud company safety moment, we want to hear from you! If you have a safety story to share, please email safetystories@bcsp.org, and a member of the BCSP team will reach out to you. Your story could be featured on the BCSP social media channels, a promotional video, or many other avenues.

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