COR Registration

    Registration Date (MM/DD/YYY)

    WorkSafeBC Account Number/s

    Legal Name of Company (registered with WorkSafeBC)

    Operating Name

    Number of FTEs
    (FTE: full-time employees)

    Number of Operating Locations

    Classification Unit

    Classification Unit 2 (if applicable)

    Classification Unit 3 (if applicable)

    Classification Unit 4 (if applicable)

    First & Last Name of Company Contact

    Title of Company Contact

    Company Address


    Company Phone Number

    Company Fax Number

    I have read and agreed to the Terms of Participation and wish to participate in AgSafe's Certificate of Recognition Program

    I commit that our company will endeavour to develop our OHS Program to the AgSafe COR Standard, to achieve Certification