Greentown Employee Induction Record

• Site conducted / Location`-
  Address

• Conducted on

  Date

• Induction delivered by

  Sign

• Name of Inductee

  Sign

• Position/Role applied for

• Start/commencement of employment

  Date

• Do you have a full UK driving license

  Yes

  No

  N/A

• if yes, please provide driving license number

• Expiry date

• Photo of front and back as well as paper counterpart

  Media

Competency Card (PTS) Railway Works only - Move to qualifications and certifications if N/A

• Do you have a current and valid rail competency card? (If N/A please move to next section)

  Yes

  No

  N/A

• please indicate below which competencies you hold and the dates obtained (Photo of card required)

  Media

• PTS

  Date

• TSC

  Date

• EO

  Date

• PICOP

  Date

• LOOKOUT

  Date

• POINTS OPERTAOR

  Date

• ENGINEERING SUPERVISOR

  Date

• RRVO

  Date

• RRVC

  Date

Qualifications and certification

• Please indicate below which current qualifications/training certificates you hold and expiry date of each one. Photograph each one in turn as evidence for records)

  Media

• Manual handling

  Date

• CSR/Safe Pass

  Date

• First Aid

  Date

• Working at height

  Date

• Small tools - Rail

  Date

• Fire safety / Warden / Awareness

  Date

• COSHH Awareness or Assessment

  Date

• Excavator / 360

  Date

• Telescopic Boom Lift (Telly Handler)

  Date

• IPAF MEWP

  Date

• Chainsaw

  Date

• Dumper

  Date

• Other - Please specify and photograph accordingly as evidence.

Railway Medical (Occupational Health and Drug and Alcohol Screening)

• Do you have a copy of your Drug and Alcohol screening report and medical fitness report (Occ Health)

  Yes

  No

  N/A

• Date of Expiry

  Date

• Please provide the certificate for both (Electronic or paper copy)

  Media

Health Questionnaire: Please answer the following questions truthfully. Greentown must be satisfied that potential employees have the health and fitness necessary to fulfil their role and are going to be able to give regular and effective attendance. Should you give particulars, or answers which are found to be false, you will be liable to disqualification or if appointed, to dismissal. Do have, or have you ever suffered from the following:

• a. Asthma, bronchitis, TB or any chest trouble

  Yes

  No

  N/A

• b. Epilepsy, fainting attacks or blackouts

  Yes

  No

  N/A

• c. Dermatitis or any other skin complaint

  Yes

  No

  N/A

• d. Liver, kidney, bladder trouble or jaundice

  Yes

  No

  N/A

• e. Problems affecting back or neck

  Yes

  No

  N/A

• f. Giddiness or headaches

  Yes

  No

  N/A

• g. Varicose veins

  Yes

  No

  N/A

• h. Problems affecting limbs or joints

  Yes

  No

  N/A

• i. Arthritis, rheumatic fever, rheumatism or gout

  Yes

  No

  N/A

• j. Diabetes

  Yes

  No

  N/A

• k. Wrist or arm problems (including Osteoarthritis, tenosynovitis, carpal tunnel syndrome or other injury

  Yes

  No

  N/A

• l. Stomach or bowel disorder

  Yes

  No

  N/A

• m. Anaemia

  Yes

  No

  N/A

• n. Nervous or psychiatric disorder

  Yes

  No

  N/A

• o. Have you any other conditions which could affect this application

  Yes

  No

  N/A

• Are you at present under any medical treatment or observations, or have you been in the last 5 years?

  Yes

  No

  N/A

• Have you ever had to leave employment, or had your employment terminated on the grounds of ill health or poor attendance?

  Yes

  No

  N/A

• Is your eyesight considered satisfactory for all normal purposes, with or without glasses?

  Yes

  No

  N/A

• How many working days have you lost due to illness in the last two years?

• If you have answered YES to any of the above please provide full details of condition, length of time and any medication prescribed for same.

• I declare that all the foregoing statements are true and complete to the best of my knowledge and belief. I consent to my doctor being approached for further information, including medical reports if the company considers it necessary. I understand that any attempt to falsify answers, or omit information that I know of in relation to my health, that may hinder or restrict me in my duties as described within my employment contract, may result in termination of my contract of employment.

  Sign

Health and Safety Policy, Safety Statement and associated documentation.

• Do you know where to locate the Greentown Health and Safety Policy and Statements?

  Yes

  No

  N/A

• By way of signature, I agree that the Greentown health and safety policy and accompanying safety statement has been communicated and fully explained to me.

  Sign

• Do you know where to locate all other relevant supporting health and safety information and documentation (Risk assessments, SOP's. method statements and policies etc. applicable to my role)

  Yes

  No

  N/A

• By way of signature, I agree that the Greentown health and safety supporting documentation has been communicated and fully explained to me.

  Yes

  No

  N/A

• As an employee of Greentown, it is essential that you understand and adhere to the health and safety rules and guidelines established by the company. Compliance with these protocols is vital for maintaining a safe working environment for yourself and your colleagues and any others who may be affected by your acts or omissions. By participating in this induction, you acknowledge and agree to the following: 1. Commitment to Safety: You will prioritize health and safety in all aspects of your work. This includes being aware of your surroundings, identifying potential hazards, and taking appropriate preventive measures. 2. Following Guidelines and procedures: You must follow all health and safety policies and procedures as outlined in the employee handbook and safety training materials. This includes but is not limited to the proper use of personal protective equipment (PPE), safe operation of machinery/tools/equipment, adherence to emergency protocols, and abiding by all worksite rules, regulations and guidance at all times. 3. Reporting Hazards: You are required to report any unsafe conditions, incidents, or near misses to your supervisor or the designated safety officer immediately. 4. Cooperation in Training: You agree to participate actively in all health and safety training sessions and to seek clarification from your supervisor if you do not understand any aspect of the safety procedures. 5. Personal Responsibility: You recognize that neglecting health and safety guidelines can result in injury, illness, or even loss of life. Therefore, you accept responsibility for your actions and their impact on your safety and the safety of others. 6. Consequences of Non-compliance: Failure to comply with Greentown health and safety rules, or any worksite health and safety rules may result in disciplinary actions, which could include suspension or termination of employment. By signing below, you confirm that you understand this disclaimer and the importance of following health and safety rules and guidance at all times.

  Sign