Trained Name

Process/Machine

Workplace Induction
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Date:
Trainer Name:
Trainer Signature:
Trained Signature:

Legend:
1 – Requires supervision 2 – Requires minimum supervision 3 – Can work unsupervised 4 – Able to train others

This form is to be signed by the employee to acknowledge that that they have received and understood the training skill levels, and then co-signed by the trainer. Any changes to the skill levels are to be initialed and dated.

Training Reviews should occur on the following basis:

Level 1 – after 2 – 3 months Level 2 – after 4 – 6 months Level 3 – after 12 months Level 4 – after 2 – 3 years