2026 Small Business Safety Awards application

*Indicates required field

Business information

Business name *

WSIB account number *

Business contact (first name, last name) *

Business contact's title *

Business contact's phone number *

Business contact's email address *

Business website

Address *

City *

Postal code *

Is your business a member of the Health and Safety Excellence program? *

Yes

Eligibility questions

Is the business independently owned and operated? *

Yes

Does the business have at least one paid employee (not including the owner/operator)? *

Yes

Does the business have fewer than 50 paid employees? *

Yes

Is the business registered with the WSIB? *

Yes

Is the WSIB account in good standing (e.g., all premiums and other amounts owing to the WSIB is paid and up to date)? *

Yes

Since the business started have there been any convictions under the Workplace Safety and Insurance Act? *

Yes

Since the business started have there been any fatalities in the workplace? *

Yes

Since the business started have there been any convictions under the Occupational Health and Safety Act or Employment Standards Act? *

Yes

Does the business have any pending fatality claims? *

Yes

Have you implemented the solution or change you’re highlighting in your application within the past 24 months? *

Yes

What does your business do? *

How long have you been in business? *

In which industry sectors does your business operate? *

How did you hear about the Small Business Safety Awards? *

WSIB website

WSIB social media

WSIB email

WSIB employee

Health and Safety Excellence program provider

Health and safety association (Public Services Health & Safety Association, Workplace Safety North, Infrastructure Health and Safety Association, Workplace Safety & Prevention Services, etc.)

LinkedIn advertisement

Online magazine/news article

Other

WSIB employee

Health and Safety Excellence program provider

Health and safety association

Other

Questions

Tell us about the health and safety issue you addressed within the past 24 months *

What health and safety challenge were you trying to solve? Please tell us what was happening and what risks or hazards were involved.
What did you change to fix it? For example: new equipment, a new process, training, protective gear or something else.
How do you know the change helped? Please share any results, numbers, observations or employee feedback that show the difference it made. Examples may include fewer incidents, fewer near misses, reduced hazards, improved reporting, safer behaviours, or worker feedback.

Tell us what made this solution work well for your business *

What made your approach new, different, creative or especially helpful for your business?
How did you make this work with your time, budget or resources?
What challenges did you face when you put this solution in place, and how did you handle them?

Tell us how employees were involved *

How did you involve employees in spotting the problem or helping with the solution?
How did you introduce the change to employees? For example: training, demonstrations, team meetings or something else.
How is the change being used in everyday work?
How will you make sure this change lasts over time?
What feedback did employees give you, and did it lead to any improvements?

What can other small businesses learn from you? *

Could another small business use your idea?
What would they need to get started? For example: time, cost, tools, support, training or equipment.
What advice would you give another small business trying to solve a similar problem?

Photos or files that show your health and safety solution

You can upload photos, a short video, or other files to help show your solution.

You can upload a maximum of three files.

10 MB limit.

Allowed types: jpg, png, txt, pdf, doc, docx, ppt, pptx, mov, mp4.

Candidate attestation:

I verify that the information in this application is true and correct to the best of my knowledge and belief and fairly represents my business’s affairs.

I understand and agree that, by submitting this application to the Small Business Safety Awards, the WSIB may use, reproduce, publish, adapt, summarize and share my business name, logo and information contained in this application, including descriptions of our health and safety initiatives and achievements, for the purposes of administering the awards program, recognizing winners and finalists, and promoting health and safety awareness and peer learning among Ontario businesses.

I authorize the WSIB to publicly disclose and use my business name, logo, municipality/location, and information from this application in connection with those purposes, including through the WSIB’s website, reports, presentations, educational materials, news releases, social media channels, and other communications.

I verify that I’m authorized by the business named on this entry form to provide the information in this application and to provide the consents described above on behalf of the business.

I further represent that the information submitted does not infringe the intellectual property, privacy, or other rights of any third party and that any necessary permissions or consents required to permit the WSIB’s use of the submitted information as described above have been obtained.

I understand the WSIB’s decisions about the awards are final. I understand the WSIB will not provide individual feedback on my application.

Business contact electronic signature *

Date of submission *