Safety Contract

This is to certify that I, ___________________________, have been

instructed in the following safety components:

1. Safety Rules
2. Location and usage of:

 Aprons
 Goggles/goggle cabinet
 Exhaust fan
 Eye wash
 Fire alarm
 Fire blanket
 Fire extinguishers
 First aid kit
 Gas shutoff switch
 Fume hood
 Safety shower
 Strikers

Student Signature and Date