Missouri Department
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 Industrial Relations
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Division of Labor Standards
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Managing Worker Safety and Health

APPENDIX 11-1

EMPLOYEE TRAINING RECORD


Name of Employee: __________________________________________________

Employee Number: __________________________________________________

Department: ________________________________________________________

Occupation(s): ______________________________________________________

TRAINING SUBJECT DATE
TRAINED
DATE RE-
INSTRUCTED
COMMENTS
       
       
       
       
       
       

I have received and understood the safety and health training/repeat instruction list above and acknowledge that it has been given to me in my native tongue.

EMPLOYEE SIGNATURE DATE SUPERVISORS SIGNATURE DATE