Name(Required) First Last After taking the written test, complete this page with your trainer. Check the box as you review each item with your trainer.Checklist OSHA 1910.178 is available at all times on site. Written test completed and reviewed with trainer. Equipment inspection requirements. Proper way to drive and use a forklift. Employee Responsibility & Consent • I have received Powered Industrial Truck training as outlined above. • I agree to use all Powered Industrial Turcks as required by the manufacturer's guidelines, and OSHA and Hogan & Associates rules. I understand that failure to do so may result in disciplinary action up to and including termination of employment.Trainee SignatureSignature(Required) Reset signature Signature locked. Reset to sign again Date(Required) MM slash DD slash YYYY Trainer (Qualified Person) E-Signature I verify the above actions have taken place to my satisfaction, and that I have reviewed the Employee Responsibilities listed above and am satisfied the trainee understands them.Name(Required) First Last Date(Required) MM slash DD slash YYYY
