2025 STSC Item Writing Panel Form

2025 STSC Item Writing Panel Form

Please complete this form to be considered for BCSP's upcoming STSC

Item Writing Panel activity by completing the fields with a red asterisk.

General Information

Prefix

Select

First Name*

Middle Initial

Last Name*

Email*

Mobile Phone Number*

Phone

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

CUST ID*

Enter your 10-digit Customer ID number here (found under your name on the left side of the page...ex. 1001XXXXXX)

Demographic Information

City*

(if not applicable, type, "N/A")

State*

Select

Country*

Select

If other Country, please list

Region*

Select

Gender*

Select

Age*

Select

Race/Ethnicity*

Select

Employment Information

Industry*

Select

Employer*

Job Title*

International Experience

International Experience*

Select

List Country/Countries

Select or enter value

Previous BCSP Panel Participation

Previous BCSP Panel(s)

Resume Upload

Resume Upload*

Drag and drop files here or

Share Your Safety Stories With Us!

We want to tell your safety story.

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! Your story could be featured on the BCSP social media channels, a promotional video, or many other avenues.

Send me a copy of my responses

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