Regional Partner Materials Request (Safety DVDs)

The primary point of contact for each approved CGA Regional Partner is able to request 811 Safety Awareness DVDs on an annual basis.  Please complete the form below to submit a request.  Once your request is approved, you will receive an email confirming shipment.  If you have any questions related to this request for, please submit to

Please provide the name of your regional partner organization. Please note, only one request can be submitted per regional partner group.
Select "yes" if the mailing address provided is a personal residence.