Speak up, Step up workshop request form

Fill out this form if you'd like a Speak up, Step up workshop at your workplace.

This workshop can support you to identify some of the common engagement and participation issues your workplace might face.

1. Contact information

Name of person requesting this workshop: (required)

Job title:

Company and location: (required)

Email address: (required)

Phone number:

2. Workshop information

Approximately how many people will be attending? (required)

What is the location/s of the site where you want the workshop delivered?

If more than one, please specify all locations

Please specify where your business or organisation is located

Anything else you'd like us to know?

Why we need this information

WorkSafe needs to collect the information on this form so that we can better understand your business and workforce needs to plan how to best deliver the workshop for you. The information you provide is essential to support us to support you, and if information isn’t provided on the form you won’t be able to submit the workshop request. Information submitted on the form may also be used for reporting and research on the delivery of the Speak up, Step up programme.

The information you submit will be kept as outlined in WorkSafe’s Privacy statement and policy

If you have any concerns about the data collected on this form, please contact us on engagementrequests@worksafe.govt.nz

Speak up, Step up workshop request form

Why we need this information

Links