Microsoft Word - Worksite Acknowledgement Form

LA:RISE 6.0 WORKSITE ACKNOWLEDGEMENT FORMWORKSITE INFORMATION Worksite Name:Worksite Address:Worksite Telephone Number:Worksite Supervisor:To report absence or tardiness call:I, , agree and affirm the following information has been reviewed(Participant Name)and provided to me:Please initial belowSupervisorParticipantLA:RISE Program OverviewLA:RISE Program Guidelines and ProtocolsJob Duties and ExpectationsTraining ScheduleWork ScheduleBreak SchedulePay RateInjury Prevention and Safety ProceduresWorker’s Compensation BenefitsProcedure for employee complaints regarding safety and healthAmericans with Disabilities Act (ADA) InformationEmergency and Evacuation Plan InformationParticipant Printed Name: Participant Signature: Date: 688975201295Worksite use only:I agree and affirm the information listed above has been reviewed with ________.(Participant Name)Worksite Supervisor Printed Name: Worksite Supervisor Signature: Date: 00Worksite use only:I agree and affirm the information listed above has been reviewed with ________.(Participant Name)Worksite Supervisor Printed Name: Worksite Supervisor Signature: Date: ................
................
In order to avoid copyright disputes, this page is only a partial summary.
To fulfill the demand for quickly locating and searching documents.
It is intelligent file search solution for home and business.
Related searches
- employee acknowledgement form template
- microsoft word change word throughout
- notice of acknowledgement form nys
- free microsoft word form templates
- final paycheck acknowledgement form template
- policy acknowledgement form template
- employee handbook acknowledgement form sample
- employee handbook acknowledgement form pdf
- microsoft word form template
- notice of acknowledgement form california
- microsoft word online free download word 2010
- microsoft word form auto populate