Title Page
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Site conducted
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Conducted on
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New Employee or Volunteer Name
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Inducted by
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Location
Induction Content - refer to the Safety Induction Manual
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I am aware of my Rights and Responsibilities especially in relation to Health and Safety
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I am aware of my PPE requirements
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I am aware of the training requirements
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I am aware of how to report a hazard
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I am aware of how to report an incident
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I am aware of the emergency procedures for this workplace and where to assemble in an emergency
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I know where the fire extinguishers are
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I know who the fire wardens and first aiders are
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I know where the first aid kits are
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I know where the break room, toilets, eating and drinking facilities are
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I understand our bullying and harassment policy
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I understand our injury management programme
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I have read and understand the hazard identification register
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If I am using a computer I have read the Computer User Fact Sheet
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If I am using ladders and stepladders I have read the Fact Sheet
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If I am manual handling and lifting I have read the Fact Sheet
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If I am using equipment, machinery and tools, I am trained and competent to do so
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I have seen the drug and alcohol policy
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I have attached a photo of my drivers licence to this question
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I confirm that I have received and read the Safety Induction Manual. I agree to abide by the rules and guidelines contained therein. I acknowledge my acceptance of these rules (and any other Health and Safety requirements that may be implemented during my employment) as a condition of employment and will abide by any lawful instruction given to me by an authorised person. I have been given and understand the information relating to the above topics, and understand my responsibilities to comply
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Inductors Signature
