Title Page
School Safety Induction Form
-
Document No.
-
Company Name
-
Manager's Name
-
Conducted on
-
Name of person completing this form
-
Please complete this form and email a copy to your manager prior to undertaking any work for, or on behalf of the company. If you have any difficulty completing a section of the form, please call the school office for assistant
-
I agree to refrain from smoking on the site (unless in dedicated smoking area specified by the school)
-
If you disagree, you must explain why?
-
I will not take drugs or drink alcohol on site, when driving company vehicles or on any other company business
-
If you disagree, you must explain why?
-
I have been shown the company health and safety policy and where to gain access to the associated procedures and reporting forms
-
If you disagree, you must explain why?
-
I will report all site or other associated work based hazards, accidents, incidents and near misses to my manager immediately and report the incident in writing within 24 hours of the event
-
If you disagree, you must explain why?
-
I am aware of the company and site emergency procedures and the location of the assembly point
-
If you disagree, you must explain why?
-
I am aware of the precautions required to do my job safely and what personal protective equipment to where (if applicable)
-
If you disagree, you must explain why?
-
I agree to keep my working area clean and tidy on a daily basis
-
If you disagree, you must explain why?
-
If using a company computer, phone or other electronic device, I agree to use it ONLY for company business. All unauthorised use will be subject to the company's disciplinary procedures
-
If you disagree, you must explain why?
-
I have been shown the location of the workplace amenities (toilets, wash areas, staff room etc)
-
If you disagree, you must explain why?
-
Prior to driving a company vehicle or other plant and equipment on a New Zealand road or highway, I will provide a copy of my current licence to the office. I will not drive if disqualified
-
If you disagree, you must explain why?
-
If hurt myself and require first aid, I know where to go, who to contact and the procedure to follow
-
If you disagree, you must explain why?
-
I agree to disclose any health condition I have, which could have an impact on my own safety, or that of other people I come into contact with on school business
-
If you disagree, you must explain why?
-
I know the name of my safety rep and what to do should I have a safety concern or grievance with another staff member, student, contractor or visitor during an at work based activity
-
If you disagree, you must explain why?
-
I am aware that contractor's and visitor's must be escorted when walking around the site (unless they have been fully inducted and authorised by a member of the senior management team)
-
If you disagree, you must explain why?
-
I hereby notify that I have completed this form to the best of my ability and all of the questions have been answered truthfully
-
Signed By
