Register for EMsafe

Employer's Mutual

Register for EMsafe

Employer / Organisation Details

Business / Organisation Name *

Policy / Employer / Employer Registration Number *

Business Address *

Suburb *

Postcode *

Brokerage / Industry Association (if applicable)

User Details

First Name *

Last Name *

Mobile Phone *

Email *

As the EMsafe Master Owner, you will receive emails to help establish and maintain the Work Health and Safety program for your workplace. Once registered for EMsafe, you can create up to 100 additional EMsafe accounts using the User Management module within your EMsafe workplace area. Should you wish to create more than 100 accounts, please contact our Mutual Benefits team at mutualbenefits@eml.com.au

Declaration by employer or their authorised representative

I declare that the information provided in this request is true, correct and complete. I consent to the use of the information provided in this form, and any further information provided, for the purpose of evaluating and administering EML Mutual Benefits and related purposes. I am authorised by the employer to complete this form and submit this declaration on behalf of the employer.

Yes, I have read and acknowledge the declaration *

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Register for EMsafe

Register for EMsafe