Safety Training Acknowledgment Form printable pdf download

Safety Training Acknowledgment Form

SIGNATURE STAFF RESOURCES

_Safety & Injury Prevention Program

Procedures Manual

EMPLOYEE SAFETY ORIENTATI0N AND TRAINING PROGRAM

SAFETY TRAINING ACKNOWLEDGMENT FORM

DATE OF TRAINING SESSION: __________________

PERSON CONDUCTING: Printed Name: ___________________________________

Title:

___________________________________

Affiliation (if not employee): _________________________

Signature:

___________________________________

TOPIC/SUBJECT MATTER COVERED: _______________________________________

__________________________________________________________________________

__________________________________________________________________

ACKNOWLEDGEMENT: By signature below, “I acknowledge that I have attended this

training session. Through the discussion and presentation of the subjects covered and the

interaction of this session, I understand how the issues, materials and subjects covered apply

to me and the completion of my job duties in a safe manner. I agree to apply the information

presented to my job to the best of my abilities.”

ATTENDANCE ROSTER:

PRINTED NAME

SIGNATURE

Safety Training Acknowledgment Form