Scribd
Upload
7K views2 pages

HSE Induction Record

This document contains an HSE induction record for a construction project. It consists of 3 sections: 1) Employer details and declaration confirming an employee completed induction training. 2) Employee details including name, address, occupation, certificates, first aid qualifications, employment history, and emergency contacts. 3) An acknowledgment signed by the employee stating they attended induction training and will follow safety guidelines and rules.

Uploaded by

Winnie Eldama
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
7K views2 pages

HSE Induction Record

This document contains an HSE induction record for a construction project. It consists of 3 sections: 1) Employer details and declaration confirming an employee completed induction training. 2) Employee details including name, address, occupation, certificates, first aid qualifications, employment history, and emergency contacts. 3) An acknowledgment signed by the employee stating they attended induction training and will follow safety guidelines and rules.

Uploaded by

Winnie Eldama
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd

HSE Induction Record

Project: Project No.:

1. Employer Details And Declaration (this Section 1 to be completed by the Employer)


Employer Name: Code No:

Employer Telephone No:


Address:

I/We confirm that the employee named in Section 2 below has successfully completed Induction
Training for the Project’s Occupational Health and Safety System
Employer / Employers Date:
Representative:

2. Employee Details (to be completed before Section 1 is signed)

Name (surname): (Given Names):

Address:

Telephone No:

Occupation: Date of Birth:

Certificates of
Competency / Tickets:

First Aid Certificate: Yes / No Expiry Date:


Level:

History Of Employment (list at least the last 2 YEARS of employment in the Construction Industry)

Employers Name, Address Start Finish


Date Date

2
3

Proof Of Identity (to be presented at the induction course)


Drivers License No: Expiry Date:

I.D. Card No.

Form No: Rev No: 0 Page : 1 of 2


HSE Induction Record

Emergency Contact Details

Name of Relationship:
Contact:

Address: Phone No (H):

(O):

3. Acknowledgment (to be signed by the employee)

 I hereby acknowledge that I have attended the Induction Course on Occupational Health, Safety &
Environment and undertake to follow the guidelines given and all Site Safety Rules to the best of
my ability.
 I certify that the information provided is true and correct.
Signed: (Employee) Date:

Induction Card No.:

Form No: Rev No: 0 Page : 2 of 2

You might also like