Form L - OSH Awareness Activity Notification

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ADOSH-SF – Forms
Form L – OSH Awareness Activity Notification - Version 4.0 – 15th July 2024 Page 1 of 2
Form L
Awareness Activity Information
Entity Name:
SRA Name:
Type of Awareness Activity: Event Media Activiy OSH
Publication Safety Alert
Start Date of Awareness Activity: --/ -- / ---- Intended End Date: --/ -- / ----
Contact Person Name: Phone Number:
Contact Persons Role: Email Address:
Entity Undertaking
Awareness Activity: Sector Regulatory Authority Government Entity
ADPHC Participation, Involvement,
Assistance Requested: No Yes Details:
Description of Activity:
Details:
Awareness Activity Materials
Attached (soft or hard copy), if
applicable:
(eg. Program of Workshop, Presentation
Slides, Media Releases / Brochures /
Posters /etc)
Attached
Not Applicable
Details:
Intended Audience:
(eg. Sector Entities, Media, General
Community, Employers, Contractors, etc)
Opportunity to Coordinate with other
Stakeholders?
Yes
No
ADPHC
Other SRA’s
Government Departments
Other Relevant Authorities
Does the Awareness Material
Intend to refer to the ADOSH-SF/
ADPHC or display the ADPHC
Logo?
Yes No
Other Relevant Information:

ADOSH-SF – Forms
Form L – OSH Awareness Activity Notification - Version 4.0 – 15th July 2024 Page 2 of 2
Form L
ADPHC Official Use
 Awareness Activity Approved as Submitted
 Modifications Required (Resubmittal Required)
Details of Modifications Required:
Competent Authority Stamp Reviewed by:
Name:
Signature:
Date: (DD/MM/YYYY)