Information
-
Prepared by
-
Conducted on
Personal Details
-
Surname
-
First Name
-
Contact number
-
Current Site
-
Classification
- Administrator
- All Rounder
- Engineer
- Fitter
- Labourer
- Operator
- Safety Advisor
- Serviceman
- Senior Management
- Trainer
- Supervisor
- Other
-
Specific Position (labourer etc)
You are only required to fill out one of the following two sections, either 'Resignation Details' or 'Dismissal Details'.
Resignation Details
-
Date notice was given
-
Number of days' notice was given
-
What is their last working day
-
Did they work out their notice
Deductions
-
Please specify to be followed up by HR (flights, courses, etc.)
Dismissal Deatils
-
Was the employee given notice
-
If so, what date
-
How much notice was given
-
What is their last working day
-
Reason for Dismissal
- Lack of Work
- End of Contract
- Poor Attendance
- Drugs/Alcohol
- Misconduct
- Unsafe Work Practices
- Poor Work Performance
- Unsuited to Work
- Accommodation Withdrawn
- Other
-
Provide Details
Performance Report - MUST BE COMPLETED
-
Standard/Performance
1-2 Unacceptable
3-4 Poor
5-6 Acceptable
7 Good
8 Very Good
9 High
10 Excellent -
Comments
-
Comments
-
Comments
-
Comments
-
Comments
-
Comments
-
Is this person suitable for re-employment in the future
-
Additional Comments
-
Supervisor/Senior Management Signature