PIN/KEY Registration

To request a PIN/KEY, fill in the information below and click the "Get PIN/KEY..." button.  By providing this information, you certify that you are the person identified by these items.  Your PIN/KEY can also be used to submit addtional attachments electronically.

Step 1:  Enter your company information
Step 2:  Submit your registration by clicking the "Get PIN/KEY" button below
Step 3:  Receive your PIN/KEY instantly 
Step 4:  Save your PIN/KEY for future use - only valid with this application
Step 5:  Click on "Start Grant Application" link to begin your Grant Application


COMPANY INFORMATION------------------------------------------------------------------------------------------

Company name: *
 Authorized person first name: *
Authorized person last name: *  
Authorized person's title:  *  
Worksite/correspondence address: *  
City: *
State: *
Zip: *


Are you an employer with at least one employee and have been for at least two years?
*      
Have you received a Safety Grant from DLI within the last two years?

*
Are you financially able to complete the project?
 *



* indicates required field