Latino Outreach Request

Please fill out the form below for each Latino Outreach Event you would like to request for your jobsite. Once a request is received, we will reach out to you directly to confirm the details of the Outreach Event.

This is a complimentary service available to all TEXO Contractor Members.

Please contact Kim Espinosa at kim@texoassociation.org or 214.683.5849 with any questions.

Project Information
General Contractor:*
Name of Project:*
Type of Project:*
Project Address:*
Project Team Information
Project Manager Name:*
Project Manager Cell Phone Number:*
Superintendent Name:*
Superintendent Cell Phone Number:*
Safety Director Name:*
Safety Director Cell Phone Number:*
Site Contact for Scheduling - Name:*
Site Contact for Scheduling - Cell Phone Number:*
Date of Requested Outreach Event*
Date Format: MM slash DD slash YYYY
Authorization To Enter Worksite & Perform Analysis Granted By:
IMPORTANT - PLEASE COMPLETE THIS SECTION
I grant permission to TEXO Safety to enter the jobsite and conduct an Outreach Event.*
- Yes
- No
Company:*
Name:*
Title:*
Date:*
mm/dd/yyy
Date Format: MM slash DD slash YYYY
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Phone
This field is for validation purposes and should be left unchanged.

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Project Information

Project Team Information

Authorization To Enter Worksite & Perform Analysis Granted By:

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