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2025 EMS Silver Application

2025 EMS Safety & Loss Control Recognition Awards Application

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DUE DATE: 01/22/2025

SILVER LEVEL

To achieve a Silver Level award, your service must comply with all Bronze Level AND Silver Level items. Be sure to submit the Bronze and Silver Level applications. Please answer yes or no to the questions below and attach information/documentation where requested. To be eligible for a Silver Level award in 2025, your service must have had a representative(s) attend the 2024 Annual SD Ambulance Association Conference.
* Safety Committee - date formed, number of members, date of last meeting, minutes of meetings for past 12 months * Safety Coordinator - date appointed, duties of Safety Coordinator, etc.
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    * Attach written policies or an explanation of how the program works. * If submitted previously, only send a new copy if revised. Note in comments if previously submitted.
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    Accepted file types: jpg, pdf, Max. file size: 2 GB.
      * Attach a training roster noting the training date(s), trainer, attendees, and the kind of training (safety committee meeting, video, online, in person, etc.).
      Untitled(Required)
      Drop files here or
      Accepted file types: jpg, pdf, Max. file size: 2 GB.
        * Attach a training roster noting the training date(s), trainer, attendees, and the kind of training (safety committee meeting, video, online, in person, etc.).
        Untitled(Required)
        Drop files here or
        Accepted file types: jpg, pdf, Max. file size: 2 GB.
          * Attach written policies or an explanation of how the program works. *If submitted previously, only send a new copy if revised. Note in comments if previously submitted.
          Untitled(Required)
          Drop files here or
          Accepted file types: jpg, pdf, Max. file size: 2 GB.
            Safety Benefits, Inc. South Dakota

            Safety Benefits Inc.
            602 E. State Street
            Plankinton SD 57368

            605.334.9567
            888.313.0839

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