Card Manager Application

1. Select One
   • Owner
     If you are a construction end user or an owner’s representative, you can apply to have access to Safesite©. Please note that an owner company must be a member of the CCS Association in order to gain access to CCS Card data. CCS will review your request and notify you when your account is activated.
   • Contractor
     If you are a contractor and would like to be able to view CCS Card status, please register here. CCS will review your request and notify you when your account is activated.

If you have any questions, please call Brooke Paddack, CCS Association Coordinator at 239-341-4107 or email brooke@ccs-safety.org.

1. First Name
2. Last Name
3. Address
4. City
5. State
6. Zip
7. Phone #
8. Fax # (optional)
9. Company Name
   AES Allison Transmission Citizens Energy Clif Bar & Company Community Health Corteva Crystal Clean Duke Energy DuPont – Terre Haute Eli Lilly and Company Employ Indy Eskanazi Health Evonik Corporation Hoosier Energy I.U. Health IBEW 538 Indiana Testing Ingredion Jefferson County Schools Purdue University Roche Diagnostics Subaru-SIA University of Cincinnati Vectren Vertellus Specialties Wabash Valley Power
10. Company Name
11. What company is requiring that you get CCS cards?
12. Job Title
13. Email
14. Confirm Email
15. Username