Presorted Standard

US Postage Paid
Permit No. 157
Division of Industrial Safety & Health
Topeka, KS
800 S.W. Jackson Street, Suite 1500
Topeka, KS 66612-1200

296-58

RETURN SERVICE REQUESTED

Kansas
58th Annual
Safety & Health
Conference

Register
Today!

58th Annual
Safety & Health Conference

October 2 - 5, 2007
Hyatt Regency Wichita – Wichita, Kansas

Sponsored by: Kansas Department of Labor

Endorsed by: Kansas Hospital Association – Kansas Self-Insurers Association
 CONFERENCE INFORMATION AND REGISTRATION
Day/Dates Activities Location
Tuesday & Wednesday, Oct. 2 &3....... Two-Day Conference Hyatt Regency Wichita
Thursday, October 4............................. Day-One – Professional Development Classes 400 W. Waterman
Friday, October 5................................. Day-Two – Professional Development Classes Wichita, Kansas 67202
Note: Special room rates are available until September 10, 2007. (316) 293-1234

AGENDA
Tim Millspaugh, Fire Marshal, Sedgwick County Fire
DAY ONE - Tuesday, October 2 Department – Wichita, KS

7:00 a.m. Registration  Industrial Hygiene Track
Industrial Hygiene Data Management Systems
7:30 a.m. Continental Breakfast Doug Niemtschk, CIH, Health and Safety Director, Koch
Mineral Services, LLC – Wichita, KS
7:50 a.m. Welcome
Pat Bush, Safety Director, Westar – Topeka, KS  Medical Track
Incident Investigation
8:00 a.m. General Session – 90 min. Greg Lenz, CSP, Senior Risk Control Consultant, ESIS
Who Is Responsible for Safety? Global Risk Control Services, Inc. – Overland Park, KS
Carl Potter, CSP, CMC, Potter & Associates International,
Inc. – Broken Arrow, OK  Safety & Management Track
The Political Incorrectness of Safety
9:30 a.m. Break Paul Maness, Quality/Safety Supervisor, Farrar
Corporation – Norwich, KS
10:00 a.m. Workshops – 50 min.
12:00 p.m. Conference Luncheon – 90 min.
 Boiler Track Awards and Recognition
Changes in the Boiler Burner Industry Jim Garner, Secretary, Kansas Department of Labor
Gene Tompkins, Director of Engineering, Webster (KDOL) – Topeka, KS
Engineering & Manufacturing Co. – Winfield, KS
1:30 p.m. Workshops – 60 min.

 Fire/Public Sector Track
 Boiler Track
What’s In Your Can…and why should you care?
(to be announced)
Jo Oliver, Environmental Project Manager, Sedgwick
County – Wichita, KS
 Fire/Public Sector Track
Office Ergonomics-One Size Does Not Fit All!
 Industrial Hygiene Track Tamara Brandt, Admin. Officer/Ergonomics Coordinator,
The Washington Buzz – What’s Happening with OH&S Sedgwick County – Wichita, KS
Issues?
Aaron Trippler, Director, Government Affairs, American  Industrial Hygiene Track
Industrial Hygiene Association – Fairfax, VA U.S. Green Building Council: LEED Certification, IEQ
and Sustainability
 Management & Medical Track Gary Ganson, CIH, CSP, MBA, Environmental Health
What You Need to Have in a Hearing Conservation and Safety Group Manager, Terracon Consultants, Inc.
Program – Lenexa, KS
Lou Di Mauro, Medical Enterprises – Omaha, NE
 Management Track
 Safety Track Accommodating the Needs of Persons With Disabilities
Reducing at Risk Behavior During Emergencies
Scott Potucek, ISO/Safety Coordinator, Sonoco Dr. Michael Fox, SC.D., Associate Professor, KUMC
Hutchinson Mill – Hutchinson, KS School of Medicine, Department of Health Policy &
Management – Kansas City, KS
11:00 a.m. Workshops – 60 min.
 Medical Track

 Boiler Track Tuberculosis: Why Should I Care?

Fundamentals of Boiler Inspection Phil Griffin, BBA, CPM, Tuberculosis Controller, Kansas

Kenneth Jones, Owner/Operator, Combustion Department of Health and Environment – Topeka, KS
Controls, Inc. – Andover, KS
Doug Stanton, Sales & Marketing, Combustion  Safety Track
Controls, Inc. – Andover, KS Safety Management for Supervisors
Mitch Ricketts, CSP, Health, Safety & Environmental
 Fire/Public Sector Track Quality Coordinator, K-State Research & Extension
Fire Inspections for Schools or “that darn Fire Marshal” – Manhattan, KS
-  -
 AGENDA
2:30 p.m. Break
2:45 p.m. Workshops – 50 min.
 Boiler Track
Boiler Refractories
Mark Schnake, Sr. Application Specialist, Harbison-
Walker Refractories Co. – Mexico, MO
 Fire/Public Sector Track
Trouble Shooting IAQ Problems
Tim Phares, CHMM, CEA, CIE, Supervisor,
Environmental Service, Wichita Public Schools –
USD 259, Wichita, KS
 Industrial Hygiene Track
Breathe Easier: Tips for Managing a Respiratory
Protection Program
Diana Czarnecki, Industrial Hygienist, American Airlines
– Kansas City, MO Steve Zink, CSP, Director, KDOL, Division of Industrial
 Management Track
HAZCOM for Supervisors (Each person attending both
hours will receive a certificate of completion, issued by iSi.)
Carter H. Moser, Trainer, iSi (integrated solutions, inc.)
– Wichita, KS (continues in next session)
 Medical Track
Drug Testing in the Workplace
Dr. Stuart Kagan, Staff Physician and Medical Review
Officer, Concentra Health Services – Lenexa, KS
 Safety Track
Living Through an Industrial Accident
Jason Marcum, Program Owner/Administrator– Lockout/
Tagout, Alcoa Aerospace Center – Hutchinson, KS
3:45 p.m. Workshops – 60 min.
 Boiler Track
Controls and Safety Devices for Automatically Fired
Boilers up to 12,500,000 BTUH
Don Jenkins, Chief State Boiler Inspector, KDOL,
Division of Industrial Safety and Health – Topeka, KS
Doyle Stone, Deputy State Boiler Inspector, KDOL,
Division of Industrial Safety and Health – Topeka, KS of Public Affairs, Park University – Kansas City, MO
 Fire/Public Sector Track
Work Zone Safety – Who Are We Trying To Protect?
Jerry Day, Traffic Operations Supervisor, Sedgwick
County-Public Works – Wichita, KS
 Industrial Hygiene Track
Conducting an Effective Employee Observation
Steve Minshall, CIH, Ash Grove Cement –
Overland Park, KS
 Management Track
HAZCOM for Supervisors (Each person attending both
hours will receive a certificate of completion, issued by iSi.
Carter H. Moser, Trainer, iSi (integrated solutions, inc.)
– Wichita, KS (continues from previous session)
 Medical Track
Proactive Solutions to Indoor Air Quality
Mark Law, Vice-President, PCI Mechanical Services
– Topeka, KS
--
Steve Rangel, President, Envirotek International,
– Topeka, KS
 Safety Track
Add to Your Bottom Line by Utilizing Advanced Medical
Employment Testing
Brian Richardson, Director of Business Development,
Physical Capacity Profile – Salina, KS
John Olson, Technical Director, Physical Capacity Profile
– Salina, KS
4:55 p.m. Exhibitor Reception – Time to Network
DAY TWO - Wednesday, October 3
7:00 a.m. Registration
7:30 a.m. Continental Breakfast
7:50 a.m. Welcome
Safety and Health – Topeka, KS
8:00 a.m. General Session – 90 Min.
Improving Safety in a Global Company
Robert C. Brayley, Executive Director, Environmental,
Health & Safety Disability Management, Textron, Inc.
– Providence, RI
9:30 a.m. Break
10:00 a.m. Workshops – 50 min.
 Boiler Track
Installation of Boilers and Pressure Vessels in the State
of Kansas
Doyle Stone, Deputy State Boiler Inspector, KDOL,
Division of Industrial Safety and Health – Topeka, KS
Ronald Sleeth, Deputy State Boiler Inspector, KDOL,
Division of Industrial Safety and Health – Topeka, KS
Charles Wilson III, Deputy State Boiler Inspector, KDOL,
Division of Industrial Safety and Health – Topeka, KS
 Fire/Public Sector Track
Organizational Causes of Accidents
Jeffery Hartle, CFPS, MIFireE, Visiting Asst. Professor
(continues in next session)
 Industrial Hygiene Track
Back-Injury Prevention Train-The-Trainer
Mitch Ricketts, CSP, Health, Safety & Environmental
Quality Coordinator, K-State Research & Extension
– Manhattan, KS (continues in next session)
**recommended – wear comfortable clothes**
 Management Track
Preventing Back Injuries and Cumulative Trauma
Disorders in the Workplace
Dr. Michael McIrvin, Doctor of Chiropractic, The Pain
Relief Center – McPherson, KS
 Medical Track
Fulfilling the Requirements of OSHA’s Bloodborne
Pathogen Standard
Betsy Gaydess, Industrial Hygienist, KDOL, Division of
Industrial Safety and Health – Topeka, KS
 AGENDA
 Safety Track Randy Mettner, Executive Officer, Adjutant General’s
Why SHARP! Department – Topeka, KS
Raymond Law, EH&S Corporate Coordinator, Cross
Manufacturing, Inc. – Lewis, KS  Safety Track
Fall Protection
11:00 a.m. Workshops – 60 min. Mike Bliss, Safety Director, Total Electric, Inc. – Wichita,
KS
 Boiler Track
Deaerator Tanks 2:30 p.m. Break
Tom Garbarino, President, BFS Industries – Butner, NC
2:45 p.m. Closing General Session – 2 hours
 Fire/Public Sector Track “Stress Down with Humor”
Organizational Causes of Accidents John Madden, Professional Speaker, Author & Trainer
Jeffery Hartle, CFPS, MIFireE, Visiting Asst. Professor
of Public Affairs, Park University – Kansas City, MO 5:00 p.m. Conference Committee Meeting
(continues from previous session)

 Industrial Hygiene Track DAY Three - Thursday, October 4

Back-Injury Prevention Train-The-Trainer
Mitch Ricketts, CSP, Health, Safety & environmental
Quality Coordinator, K-State Research & Extension
– Manhattan, KS (continues from previous session) 8:00 a.m. to 12:00 p.m.
 Management Track
Legal Issues in Construction: One Company’s
Perspective
John Sherwood, Esq., Corporate Counsel, Sherwood
Construction Co., Inc. – Wichita, KS
 Medical Track
When I’m 64
Dr. Chris Fevurly, Medical Director, Lawrence Memorial
Hospital – Lawrence, KS
 Safety Track
The Voluntary Protection Program (VPP)
David McDonnell, Compliance Assistance Specialist, US
Department of Labor, OSHA – Wichita, KS
12:00 p.m. Conference Luncheon – 90 min.
1:30 p.m. Workshops – 60 min. 10 Hour – General Industry Safety and Health Outreach Training
 Boiler Track
Refractory Repair and Boiler Safety
Chuck Wilson, President, Safety 1st – Topeka, KS Deborah Grow, Safety Consultant, KDOL, Division of Industrial
 Fire/Public Sector Track
Emergency Response on Campus
Rex Smith, Director Environmental Health & Safety
Education Services, Wichita Area Technical College
– Wichita, KS
 Industrial Hygiene Track
Effective Ventilation Systems Suck
Dianna Bryant, CIH, CSP, Associate Professor, University
of Central Missouri – Warrensburg, MO
 Management Track
The Best Way to Conduct a Termination
Dr. Lee Tyner, Assistant Professor, University of Central
Oklahoma – Edmond, OK provided will be in Spanish and English.
Professional Development Classes
Boiler Operator Training and Maintenance
Don Jenkins, Chief State Boiler Inspector, KDOL, Division of
Industrial Safety and Health – Topeka, KS
Doyle Stone, Deputy State Boiler Inspector, KDOL, Division of
Industrial Safety and Health – Topeka, KS
Ronald Sleeth, Deputy State Boiler Inspector, KDOL, Division of
Industrial Safety and Health – Topeka, KS
Charles Wilson III, Deputy State Boiler Inspector, KDOL,
Division of Industrial Safety and Health – Topeka, KS
Mitch Whisman, Special Risk Engineer Supervisor, Hartford
Steam Boiler Insurance – Bonner Springs, KS
Chuck Wilson, President, Safety 1st – Topeka, KS
8:00 a.m. to 12:00 p.m.
Hexavalent Chromium in Construction and General Industry
Helen Cook, Certified Industrial Hygienist, KDOL, Division of
Industrial Safety and Health – Topeka, KS
8:00 a.m. to 5:00 p.m.
Program
Ken Bieker, Safety Consultant, KDOL, Division of Industrial
Safety and Health – Topeka, KS
Safety and Health – Topeka, KS
Steve Lolley, Safety Consultant, KDOL, Division of Industrial
Safety and Health – Topeka, KS
Betsy Gaydess, Industrial Hygienist, KDOL, Division of Industrial
Safety and Health – Topeka, KS
8:00 a.m. to 5:00 p.m.
Safety on OSHA Standards for Spanish Speaking Employees
Tina DeLaRosa, Communications Specialist, KDOL, Division of
Marketing and Communication – Topeka, KS
Jorge DeLaTorre, Supervisor, Safety trainer, Sedgwick County
Highway Department – Wichita, KS
¡Atención! The following workshop targets your Spanish speaking
employees and those who work with them. All of the information

 Medical Track 8:00 a.m. to 5:00 p.m.

Emergency Planning for Pandemic Flu Ground Hazardous Materials Transportation (DOT) Awareness

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 AGENDA
David Cosloy, CHMM, EMT, Instructor,
iSi (integrated solutions, inc.) – Wichita, KS.
1:00 p.m. to 5:00 p.m. Professional Development Classes (Continued)
Ground Hazardous Materials Transportation (DOT) Awareness
Refresher
David Cosloy, CHMM, EMT, Instructor,
iSi (integrated solutions, inc.) – Wichita, KS.
CONFERENCE INFORMATION & REGISTRATION
Continuing Education
Health & Safety Objectives 2007
Who Is Responsible for Safety?
• Participant will learn how to take personal responsibility for safety.
• Participant will understand why it is important to take personal
responsibility for safety.
Changes in the Boiler Burner Industry
• Participant will learn how the Boiler Burner market continues to change.
• Participant will understand how political and economic forces are driving
major changes in the business.
• Participant will learn how newer technologies have completely changed
some market segments.
Boiler Refractories
• Discussion will include: refractory lining selection criteria, refractory lining
repairs, destructive service conditions affecting lining life, and heat-up/cool-
down temperature schedules.
Controls and Safety Devices for
Auto Fired Boilers up to 12,500,000 BTUH
• Will cover requirements of ASME CSD-1 for boiler fire and water side
controls up to 12,500,000 BTUH.
Installation of Boilers and Pressure Vessels in the State of Kansas
• Will cover requirements for boiler and pressure vessel installation in Kansas
including: new units, relocated vessels, bringing in used vessels from out of
state and clearances.
Refractory Repair and Boiler Safety
• Will learn about boiler safety and how it is related to boiler refractory repair
and installation.
What’s In Your Can…and why should you care?
• Participant will learn about various waste minimization efforts done in
Sedgwick County.
• Learn about latest results of their recycling program
• Learn about the creation and success of their online waste exchange.
• Learn about commitments within Sedgwick County government to buy
recycled goods.
Fire Inspections for Schools or “that darn Fire Marshal”
• Participant will learn all State of Kansas requirements for schools in the area
of fire inspections.
• Participant will learn about requirements for alarm systems, sprinkler
systems, evacuation plans, tornado plans, exit signs, exit doors, exit
corridors, flammable/combustible liquids, hazardous processes, fire drills
and much more.
• Participant will know what the inspector will be looking for before they
arrive at the school.
Office Ergonomics – One Size Does Not Fit All!
• Participant will learn about ergonomic principals and their results. Such as:
increased productivity, improve safety and health, increase work quality,
--
DAY Four - Friday, October 5
8:00 a.m. to 12:00 p.m.
10 Hour – General Industry Safety and Health Outreach Training
Program, (Continued)
lower lost time at work, lower turnover and lower work comp claims.
• Learn practical ways to assess your office workstations for a safer, more
productive workforce.
Work Zone Safety – Who Are We Trying To Protect?
• Participant will learn guidelines pertaining to safely moving traffic/workers
in and through work sites using standards from the MUTCD (Manual on
Uniform Traffic Control Devices).
Organizational Causes of Accidents
• Using case studies, the participant will review competing social science
theories and common problem areas will be identified.
• Participant will learn to identify organizational weaknesses and safety
failures.
Emergency Response on Campus
• Participant will learn what is involved in emergency response
– management commitment, establishment of crisis team, analysis of
your capabilities and hazards, compliance with regulatory requirements,
implementing your plan and training of crisis team.
• Would your personnel know what to do in an emergency?
The Washington Buzz – What’s Happening with OH&S Issues?
• Participant will learn what Congress is doing with the issues.
• Participant will learn answers to NIOSH and their involvement in OH&S
research.
Industrial Hygiene Data Management Systems
• Participants learn a variety of techniques from AIHA’s “A Strategy for
Assessing Managing Occupational Exposures.”
• Participant will learn about: designing industrial hygiene studies,
establishing monitoring schedules, and the benefits/challenges of using
various computer software in managing industrial hygiene data.
U.S. Green Building Council:
LEED Certification, IEQ and Sustainability
• Participant will learn about LEED benefits including: state of the art
strategies for sustainable site development, water savings, energy efficiency,
materials selection and indoor environmental quality.
• Participant will learn what the EHS Professional can provide: required skills
to evaluate a building to achieve the required air quality parameters.
• Program will outline and discuss the USGBC Green Building Rating
System.
Back Injury Prevention Train-The-Trainer
• Participant will learn how to care for your back.
• Participant will learn how to relieve muscle pain and spasms with simple
stretching exercises.
• Participant will learn how to pass this knowledge on to others in a fun,
informal learning environment.
Effective Ventilation Systems Suck
• Participant will learn why local exhaust ventilation systems are critical.
• Participant will learn why proper design and installation must be confirmed.
• Participant will learn some simple low cost solutions that could improve
performance.
 CONFERENCE INFORMATION & REGISTRATION
What You Need to Have in a Hearing Conservation Program
• Participant will understand what you need in a hearing conservation
program – starting with a noise survey, policy development, audiometric
testing, hearing protection record keeping and training.
• Speaker will talk about the differences in Standard Threshold Shift and
OSHA Recordable Shift.
Accommodating the Needs of Persons
with Disabilities During Emergencies
• Participant will be given an overview of disability, provide case studies and
illustrations of some of the challenges person with disabilities face.
• A discussion about some of the related challenges businesses and other
organizations face in their own efforts to assure accessibility to emergency
related activities for all employees or clients.
• Participant will learn about approaches offered from other states and from
recent research.
HAZCOM for Supervisors
• Participant will learn their company’s HCS responsibility and what the
program should contain including new OSHA initiatives and compliance
issues including proposed Globally Harmonized System of Classification
(GHS).
• Participant will learn how to use labels and material safety data sheets.
• Participant will learn how to safely handle hazardous chemicals.
Preventing Back Injuries and
Cumulative Trauma Disorders in the Workplace
• Participants learn how designing a training program which incorporates
stretching techniques reduces pain, fatigue and subsequently, lost it injuries.
• Speaker will offer tips on how to get employees to buy into the program and
how to keep it alive.
Legal Issues in Construction: One Company’s Perspective
• Participant will learn what to do when OSHA shows up and what to do after
a citation is issued.
• Participants will be encouraged to share their experiences and what they
have learned.
Incident Investigation
• Participant will be shown an overview of loss investigation techniques to
assist the first line supervisors in the process of incident investigations.
• Participants will be provided the specific steps necessary to effectively
investigate an incident.
Tuberculosis: Why Should I Care?
• Participant will learn practical insights into the current issues associated
with tuberculosis in Kansas.
• Speaker will discuss issues effecting the general public and industries in
Kansas, focusing on what is most important for safety and protection.
Drug Testing in the Workplace
• Participant will learn the history of drug testing in the federal program and
workplace.
• Participant will learn the differences between the screening test, confirmed
test, verified test and some pitfalls to avoid.
ProActive Solutions to Indoor Air Quality
• Participant will learn about RCI technology – a clean and natural process for
purifying indoor environments.
• Participants will learn the effectiveness of RCI in killing germs, viruses,
mold, fungus, etc….
• Participant will learn how many industries are now employing this RCI
technology and which ones.
When I’m 64
• Participant will learn the epidemiology of aging effects on common
musculoskeletal conditions.
• Participant will review evidence of how work interacts or changes the
natural process of aging.
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• Participant will receive recommendations for employers to deal with the
effects of aging and fitness for duty.
Emergency Planning for Pandemic Flu
• Participant will receive an update and overview of where the state stands
with planning for a response to a disaster of pandemic influenza.
• Participant will review the exercises, issues, training and planning that has
occurred over the last year along with any new legislation that has an impact
on this response.
Reducing at Risk Behavior
• Participant will review safety programs that helped Sonoco improve their
safety performance.
• Participant will understand how reducing human error can be good safety
news.
• Participant will be presented with ideas that have proven helpful to reduce
injuries.
• Participant will see an 18 minute Safety video produced by Sonoco.
The Political Incorrectness of Safety
• Participant will learn how and when to have safety training.
• Participant will enjoy a humorous look at why they need to do it!
Safety Management for Supervisors
• Participants will examine ways to involve employees in the safety process
in order to create, accomplish and measure safety objectives that are
meaningful to workers.
• Participants will receive a training manual that includes a step-by-step plan
for developing or revitalizing the company safety program.
Add to Your Bottom Line by
Utilizing Advanced Medical Employment Testing
• Participant will learn about reducing injuries by ensuring employees have
the physical strength to safely perform their job responsibilities.
• Participants will learn about reducing workers compensation exposure
by documenting impairments that an employee brings with them to the
workplace per the American Medical Association (AMA) Guides.
• Participant will learn about providing pre-injury baseline measurements on
an employee, allowing treating professionals to expedite the rehabilitation
process.
Fall Protection
• Participant will learn why we use fall protection.
• Participant will learn who should use fall protection.
• Participant will learn methods of fall protection (which includes discussion
on equipment)
The Best Way to Conduct a Termination
• Participant will learn tips regarding when to terminate.
• Participant will learn why the act of terminating is often more litigious than
the decision to terminate.
Stress Down with Humor
• Participant will learn how to enhance business/social communications with
others through humor.
• Participant will learn how to solve business/personal problems by getting a
different perspective and developing your creative mind.
• Participant will learn how to handle predictable stressors in your job and
your life.
• Participant will learn how to capitalize on the magic of self-effacing humor
and accelerate their own success by winning the respect and cooperation of
others.
Trouble Shooting IAQ Problems
• Participant will learn how to effectively assess, characterize and manage
indoor air quality concerns that can impact commercial and public
buildings.
• Participant will be lead through some common IAQ problem solving
scenarios.
 CONFERENCE INFORMATION AND REGISTRATION
Breathe Easier: Tips for Managing a
Respiratory Protection Program
• Participant will learn key elements of a respiratory protection program and
practical aspects of the day-to-day management.
• Participants will gain information and resources to initiate the update,
review, and effective management of their respirator program.
• Topics covered in this session include: choosing the right respirator, the
importance of education, fit testing, cartridge life expectancy, respirator
care, and program surveillance.
Fulfilling the Requirements of
OSHA’s Bloodborne Pathogen Standard
• Participant will learn how abiding by the bloodborne pathogen standard will
help prevent accidental exposures to bloodborne illnesses.
• This program will assist the participant in identifying what elements of the
standard they will be required to implement at their facility.
Fundamentals of Boiler Inspection
• Participant will learn the steps involved with the preparation of a boiler
inspection.
• Participant will learn what to look for during an inspection and how to test
controls.
Hexavalent Chromium in Construction and General Industry
• Participant will be acquainted with the New OSHA Hexavalent Chromium
Standards as they apply to Construction and Private Industry.
• Participant will gain an understanding of how to evaluate and control
Hexavalent Chromium Hazards.
10 Hour - General Industry Safety and
Health Outreach Training Program.
• Participants will be introduced to OSHA walking surfaces, egress and
fire protection, hazardous materials, machine guarding, electrical, hazard
communication, lockout/tagout, personal protective equipment and record
keeping.
• Trainers are authorized and students will receive course completion cards
issued by OSHA.

EXHIBITORS! EMPLOYERS

Exhibit space sales for next year’s How safe is your workplace? Schedule a
conference begin in April 2008. FREE safety consultation and find out!

Contact Dena Ackors Let us help you evaluate your workplace and
at 785-296-4386 or control hazards. No citations, No penalties,
Dena.Ackors@dol.ks.gov No charge! And it’s all confidential.
to get more information and increase Contact Lisa Hoffman at 785-296-2251 or
your ad exposure. Lisa.Hoffman@dol.ks.gov to find out more.

REGISTRATION
Attendee(s) Information

1. Name:____________________________________________ 2. Name:____________________________________________

Company Address:___________________________________ Company Address:___________________________________

City:____________________ State:_____ Zip Code:_________ City:____________________ State:_____ Zip Code:_________

Phone:___________________ E-mail:___________________ Phone:___________________ E-mail:___________________

Company Name:_____________________________________ Company Name:_____________________________________

Job Title:___________________________________________ Job Title:___________________________________________

Name on name tag:__________________________________ Name on name tag:__________________________________

Event Disclaimer: Views expressed by speakers are not necessarily the views of the Kansas Department of Labor (KDOL). All
speaker appearances are contingent upon availability. KDOL reserves the right to substitute or cancel speakers as needed.

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 CONFERENCE INFORMATION AND REGISTRATION
Registration Selections
 Conference Plus Professional Development Class (PDC)
Note: Options selected within this category include, the two-
day conference, a PDC, meals, breaks, materials and functions.
Supplemental PDCs are available at an additional cost (priced
next to each) and are not available for purchase at the Early Full
Registration rate.
____ Early Full Registration (*received by Sept. 14) ($190)
____ Full Registration ($215)
Select one of the following PDCs:
____ Boiler Operator Training and Maintenance
____ 10 Hour General Industry Safety and Health Outreach
Training Program
____ Hexavalent Chromium in Construction and General industry
____ Safety on OSHA Standards for Spanish Speaking Employees
____ Ground Hazardous Materials Transportation (DOT)
Awareness - Supplemental ($200)
____ Ground Hazardous Materials Transportation (DOT)
Awareness Refresher - Supplemental ($150)
 Two-Day Registration (Does not include PDC)
Note: Includes meals, breaks, materials and functions.
____ Early Two-Day Registration (*received by Sept. 14) ($155)
____ Two-Day Registration ($185)
 Single-Day Registration
Note: Includes meal, breaks materials and functions on the day
selected.
____ Tuesday ($95)
____ Wednesday ($95)
 Professional Development Class (PDC) Only
Note: Classes selected within this category include breaks, and
materials. Supplemental PDCs are available at an additional cost
(priced next to each) and are not available for purchase at the Early
PDC Registration rate.
____ Early PDC Registration (*received by Sept. 14) ($40)
____ PDC Registration ($55)
Select one of the following PDCs:
____ Boiler Operator Training and Maintenance
____ 10 Hour General Industry Safety and Health Outreach
Training Program
____ Hexavalent Chromium in Construction and General industry
____ Safety on OSHA Standards for Spanish Speaking Employees
____ Ground Hazardous Materials Transportation (DOT)
Awareness - Supplemental ($200)
____ Ground Hazardous Materials Transportation (DOT)
Awareness Refresher - Supplemental ($150)
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* To receive a reduced rate, mailed registration must be
postmarked and online registration must be entered by
midnight September 14. Any selection containing a choice
of Supplemental PDC is not included in reduced rates.
Special Needs - All reasonable attempts will be made to
accommodate special needs. Needs can be written below or
telephoned in advance to Dena Ackors at 785-296-4386. Persons
who require special needs are encouraged to report them prior to
the event.
Extra Meal(s) Tuesday and Wednesday
___ Continental Breakfast - Tues..........@ $10 each = $_________
___ Continental Breakfast - Wed..........@ $10 each = $_________
___ Lunch - Tues..................................@ $21 each = $_________
___ Lunch - Wed. . ...............................@ $21 each = $_________
Payment Selection
Payment is due when registration is submitted. Make checks and
money orders payable to the Kansas Safety and Health Conference.
Mail to: Kansas Safety and Health Conference
800 SW Jackson, Suite 1500
Topeka, KS 66612-1200
Registration Alert!
Save 10% when registering three or more persons at the same time.
This offer is valid only if all registrations are mailed together and
payment is made using a single Visa or MasterCard. Offer does not
include a discount on extra meal purchases.
___ Check/Money Order (KDOL FEIN is 48-6029925).
___ Interfund Voucher - This selection is available to Kansas
state agencies only. Payment must be made within SOKI.
Deduct 10 percent prior to making SOKI payment if
registering three or more employees at the same time.
(KDOL agency number is 296-000000-00).
___ MasterCard or Visa. We encourage you to use our Web site
at www.dol.ks.gov/events and select online registration.
If you choose to mail credit card payment complete the
following: _____ MasterCard _____ Visa
16-digit card number and 4-digit expiration date:
Print the name of the cardholder (as shown on the card):
_______________________________________________
Total Amount Enclosed: $_____________________________
Refund Policy
A request for refund must be made in writing and received two
weeks prior to the event. Businesses must include their company’s
Federal Employer Identification Number. Individuals must include
their Social Security Number. A $25 processing fee will be
deducted from all refunds.
 Safety & Health

G LF TOURNAMENT
October 1, 2007
Sim Park Municipal Golf Course
220 W. Murdock – Wichita, KS 67202

ENTRY DEADLINE: SEPTEMBER 26, 2007!

 Muligans can be purchased 
A reception will be held at the clubhouse immediately after the event.

Tournament fees: $45.00 per person or $180.00 per team

(includes green fees, cart, prizes and reception)

Contact: Russ Eckert at 316-268-4395 if you have any questions

Send all entries to: Dena Ackors

Kansas Department of Labor
800 SW Jackson, Suite 1500
Topeka, Kansas 66612-1200

Make checks payable to: KS Safety & Health

GOLF TOURNAMENT REGISTRATION

Four Person Scramble – Best Ball Format
 I/we want to participate in the 2007 Safety & Health Golf Tournament. 

List ALL Players, Single or Team

Single players or incomplete teams will be matched with other players and notified at the tournament.
1. Team Captain’s Name: ____________________________________ Phone:_______________________
E-Mail Address: _________________________________________ Fax:_________________________
Address: (street) ______________________________________________________________________
(city) ____________________________________ (state)__________________ (zip)_______________
2. Player’s Name__________________________________________ Phone:________________________
3. Player’s Name__________________________________________ Phone:________________________
4. Player’s Name__________________________________________ Phone:________________________

REGISTRATION is at 12:00 Noon SHOTGUN starts at 1:00 p.m.

DRESS CODE: Collared Shirts No Cut-off Shorts SOFTSPIKES ONLY