FORM 4.

1 SELF-ASSESSMENT CHECKLIST

Instruction:

This Self-Check Instrument will give trainer data or information which is essential in
planning training sessions. Please check the appropriate box of your answer.

CAN I?... YES NO

BASIC COMPETENCIES

COMMON COMPETENCIES
 CORE

Trainee’s Signature: ___________________________ Date: _______________

Facilitator’s Signature: ___________________________ Date: _______________