Template Employee Orientation Form

This Section To Be Completed By Human ResourcesDate:

 New Employee /  Transferred /  Student
Name: / Union: / Medical:
Address: / City: / Postal:
Phone: / Cell: / Other:
Birth Date: / SIN: / Care Card:
Emerg Contact: / Phone: / Relation:
Department: / Division: / Position:
DL Required:
YES NO / 5500 Kg
YES NO / Copy of Drivers Licence:
YES NO / Endorsements:

CORPORATE ORIENTATION

GENERAL – This section to be completed during the corporate orientation session
 Safety Program /  Accident Investigations /  PPE /  Workplace Violence
 Health and Safety Policy /  First Aid /  Hazard Awareness /  Housekeeping
 Responsibilities /  Claim Process/RTW /  Safety Bulletin Board /  Cell Phone Use
 Right to Refuse /  Safety Meetings /  WHMIS /  Ask For Instruction
 General Safety Rules /  Safety Committee /  Emergency / EVAC /  Equipment Operation
 Discipline Policy /  Training /  Hearing Conservation /  Drivers Program
 Reporting Procedures /  Inspections /  Ergonomics /  Practice & Procedures

SUPERVISOR SECTION

To Supervisors: Please ensure that your new employee has been oriented and instructed on the required topics. Division specific orientation items can be found below in checklist form. Once the form is completed and signed by both you and your new employee, keep a copy and return the original to Human Resources. The form will then be included on the employees personnel file.

Division Orientation

This section to be completed by employee’s supervisor
Facility Walkthrough /  Attendance /  Housekeeping /  Lockout – Lock and Key
 Lunch Room /  Smoking /  Protective Equipment /  ______
 Parking /  Safety Committee /  Working Alone /  ______
 Bulletin Board /  First Aid /  Vehicle Inspections /  ______
 Tool Area /  Evacuation Procedure /  Equipment Inspection /  ______
 MSDS Location /  Working Alone /  Safety Meetings /  ______
 Fire Extinguishers /  Traffic Control /  WCB Regulations /  ______
 Spill Kit /  Incident Reporting /  Confined Spaces /  ______

Divisional Orientation (continued)

Safe Work Procedures / Equipment Operating Guidelines (Identify all procedures or guidelines reviewed)

 Confined Space / ______
Fall Protection / ______
Lock Out / ______
Excavations / ______
Hoisting / Lifting / ______
 / ______

The following section is to assist Supervisors in identifying the required authorization / training prior to a new employee using any equipment. All equipment orientation and training performed must be documented and returned to Human Resources.

Division Equipment Authorization and Training Identification

Identify all required training
 Excavator /  Aerial Lift /  Loader /  Trailer Towing
 Flat Deck (Hiab) /  Vactor Truck /  Hoists / Lifting Devices /  Light Vehicles
 Grader /  Backhoe /  Dump Truck /  Cranes
 Paving Machine /  Forklift /  Compressor /  Roller
 Skid Steer /  Volvo /  Power Tools /  WHMIS
 Confined Space /  TDG /  Sweeper /  Dozer
 Fall Protection /  First Aid /  Milling Machine / 

Equipment Authorization and Training Is The Responsibility Of The Department

Supervisor Comments:

______

______

 N/A Identified Field Partner:______Division: ______

The identified field partner is used to ensure an employee is oriented during their exposure to fieldwork. Field partners must ensure a new employee does not attempt to perform tasks they have not been authorized or trained to do so. If this is not necessary, check N/A.

I have been instructed and understand the foregoing information.

Employee Signature: ______Date:______

I have instructed the foregoing information with the above employee and believe that he or she has a reasonable understanding of the information.

Orientator’s Signature: ______Date:______

Supervisor Signature:______Date:______

DIVISION ORIENTATION MUST BE COMPLETED PRIOR TO COMMENCING WORK

Original Copy To Be Signed And Returned To Human Resources.