EMPLOYEE TRAINING FORM – MODEL FORM

KEEP TRACK OF TRAINING HERE’S AN EXAMPLE OF AN EMPLOYEE TRAINING FORM. AS WITH ANY MODEL FORM, YOU’LL NEED TO MAKE REVISIONS DEPENDING ON WHAT KIND OF INDUSTRY YOU’RE IN AND THE SUBJECTS INCLUDED IN YOUR TRAINING PROGRAM. FOR EXAMPLE, REMOVE THE FIRST ITEM IF YOU DON’T TRAIN YOUR EMPLOYEES ON BLASTING OR EXPLOSIVES. ABC COMPANY EMPLOYEE TRAINING FORM Employee Name: ___________________________________ Department: ___________________________________ Signature: ___________________________________

Subject	Inital Training		Retraining		Retraining		Employee Certified?
	Date & Time	Trainer’s Initials	Date & Time	Trainer’s Initials	Date & Time	Trainer’s Initials
Blasting & use of explosives							Yes / No
Concrete & masonry							Yes / No
Cranes, derricks, hoists, elevators, & conveyors							Yes / No
Electrical safety							Yes / No
Employee emergency plans							Yes / No
Excavations							Yes / No
Fall protection							Yes / No
Fire prevention plans							Yes / No
General environmental controls:							Yes / No
Confined spaces							Yes / No
Lockout/tagout							Yes / No
Hazardous Materials:							Yes / No
Flammable & combustible liquids							Yes / No
Explosives & blasting agents							Yes / No
Bulk delivery & mixing vehicles							Yes / No
Storage & handling of liquefied petroleum gases							Yes / No
Process safety management of hazardous chemicals							Yes / No
Hazardous waste operations & emergency response							Yes / No
Hazardous waste cleanup							Yes / No
MSDS							Yes / No
Machinery & machine guarding							Yes / No
Materials handling & storage							Yes / No
Powered industrial trucks							Yes / No
Moving the load							Yes / No
Crawler locomotives & truck cranes							Yes / No
Motor vehicles & mechanized equipment							Yes / No
Personal protective equipment:							Yes / No
Hearing protection							Yes / No
Respiratory protection							Yes / No
Fire/burn protection							Yes / No
Powered platforms for building maintenance							Yes / No
Scaffolding							Yes / No
Stairways & ladders							Yes / No
Steel erection							Yes / No
Tools, hand & power							Yes / No
Welding, cutting & brazing							Yes / No

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