SAFETY TRAINING RECORD TEMPLATE

Company: [COMPANY NAME]
Training Program: [PROGRAM NAME]
Training Date: [DATE]
Trainer: [TRAINER NAME & QUALIFICATIONS]
Training Location: [LOCATION]

TRAINING PROGRAM DETAILS

Course Title: [COURSE TITLE]
Course Code: [COURSE CODE]
Duration: [HOURS/DAYS]
Training Method: □ Classroom □ Online □ Hands-on □ Field Training
Certification Valid Until: [DATE]
Renewal Required: □ Yes □ No
Renewal Period: [FREQUENCY]

LEARNING OBJECTIVES

Upon completion of this training, participants will be able to:
• [OBJECTIVE 1]
• [OBJECTIVE 2]
• [OBJECTIVE 3]
• [OBJECTIVE 4]
• [OBJECTIVE 5]

TRAINING CONTENT COVERED

Module 1: [MODULE NAME]
Topics Covered:
• [TOPIC]
• [TOPIC]
• [TOPIC]
Duration: [TIME]

Module 2: [MODULE NAME]
Topics Covered:
• [TOPIC]
• [TOPIC]
• [TOPIC]
Duration: [TIME]

Module 3: [MODULE NAME]
Topics Covered:
• [TOPIC]
• [TOPIC]
• [TOPIC]
Duration: [TIME]

PRACTICAL EXERCISES

Exercise 1: [DESCRIPTION]
Competency Demonstrated: □ Yes □ No
Comments: [COMMENTS]

Exercise 2: [DESCRIPTION]
Competency Demonstrated: □ Yes □ No
Comments: [COMMENTS]

Exercise 3: [DESCRIPTION]
Competency Demonstrated: □ Yes □ No
Comments: [COMMENTS]

ASSESSMENT RESULTS

Written Test Score: [SCORE] / [TOTAL] ([PERCENTAGE]%)
Passing Score: [MINIMUM PERCENTAGE]%
Result: □ Pass □ Fail

Practical Assessment: □ Pass □ Fail
Comments: [COMMENTS]

Overall Result: □ Competent □ Not Yet Competent
Remedial Training Required: □ Yes □ No

PARTICIPANT INFORMATION

Name: [FULL NAME]
Employee ID: [ID NUMBER]
Department: [DEPARTMENT]
Position: [JOB TITLE]
Supervisor: [SUPERVISOR NAME]
Date of Hire: [DATE]
Previous Safety Training: [LIST PREVIOUS TRAINING]

Contact Information:
Email: [EMAIL ADDRESS]
Phone: [PHONE NUMBER]

ATTENDANCE RECORD

Date: [DATE] | Hours: [HOURS] | Signature: ________________
Date: [DATE] | Hours: [HOURS] | Signature: ________________
Date: [DATE] | Hours: [HOURS] | Signature: ________________
Date: [DATE] | Hours: [HOURS] | Signature: ________________

Total Training Hours: [TOTAL HOURS]

COMPETENCY CHECKLIST

The participant has demonstrated competency in:

□ Hazard identification and risk assessment
□ Use of personal protective equipment
□ Emergency procedures and evacuation
□ Incident reporting procedures
□ Safe work practices for assigned tasks
□ Equipment operation and maintenance
□ Chemical handling and storage
□ First aid and emergency response
□ Regulatory compliance requirements
□ Company safety policies and procedures

Additional Competencies (Job-specific):
□ [SPECIFIC COMPETENCY]
□ [SPECIFIC COMPETENCY]
□ [SPECIFIC COMPETENCY]
□ [SPECIFIC COMPETENCY]

TRAINER EVALUATION

Participant's Understanding: □ Excellent □ Good □ Satisfactory □ Needs Improvement
Participation Level: □ Excellent □ Good □ Satisfactory □ Needs Improvement
Practical Skills: □ Excellent □ Good □ Satisfactory □ Needs Improvement

Strengths:
• [STRENGTH]
• [STRENGTH]

Areas for Improvement:
• [AREA]
• [AREA]

Additional Comments:
[TRAINER COMMENTS]

FOLLOW-UP REQUIREMENTS

Immediate Actions Required:
• [ACTION] - Due Date: [DATE]
• [ACTION] - Due Date: [DATE]

Refresher Training Scheduled:
Date: [DATE]
Topics: [TOPICS]

On-the-Job Monitoring:
Supervisor: [NAME]
Monitoring Period: [DURATION]
Review Date: [DATE]

CERTIFICATION

This is to certify that [PARTICIPANT NAME] has successfully completed the [TRAINING PROGRAM NAME] and has demonstrated competency in all required areas.

Certificate Number: [CERTIFICATE NUMBER]
Issue Date: [DATE]
Valid Until: [EXPIRY DATE]

Trainer Signature: _________________ Date: _______
[TRAINER NAME & QUALIFICATIONS]

Supervisor Signature: ______________ Date: _______
[SUPERVISOR NAME]

Training Manager: _________________ Date: _______
[TRAINING MANAGER NAME]

TRAINING EFFECTIVENESS EVALUATION

To be completed 30 days after training:

Has the participant applied the training in their work? □ Yes □ No
Are safety practices being followed? □ Yes □ No
Any incidents since training? □ Yes □ No
If yes, describe: [DESCRIPTION]

Additional training needed? □ Yes □ No
If yes, specify: [TRAINING NEEDED]

Evaluated by: [NAME] Date: [DATE]

RECORD KEEPING

Original Record Location: [LOCATION]
Copy Provided to Employee: □ Yes □ No
Copy to Personnel File: □ Yes □ No
Copy to Training Database: □ Yes □ No
Retention Period: [YEARS]

REGULATORY COMPLIANCE

Training meets requirements of:
□ OSHA Standards
□ Local Regulations
□ Company Policy
□ Industry Standards
□ Client Requirements
□ Other: [SPECIFY]

TRAINING PROVIDER INFORMATION

Organization: [TRAINING PROVIDER]
Accreditation: [ACCREDITATION DETAILS]
Trainer Qualifications: [QUALIFICATIONS]
Contact Information: [CONTACT DETAILS]

PARTICIPANT FEEDBACK

Training Quality: □ Excellent □ Good □ Satisfactory □ Poor
Trainer Effectiveness: □ Excellent □ Good □ Satisfactory □ Poor
Materials Quality: □ Excellent □ Good □ Satisfactory □ Poor
Relevance to Job: □ Excellent □ Good □ Satisfactory □ Poor

Comments and Suggestions:
[PARTICIPANT FEEDBACK]

Participant Signature: _____________ Date: _______

DOCUMENT CONTROL

Form Version: 3.0
Form ID: TR-001
Last Updated: [DATE]
Next Review: [DATE]
Approved by: [NAME & TITLE]

DISTRIBUTION:
□ Participant
□ Supervisor
□ Training Department
□ Human Resources
□ Safety Department
□ Personnel File