Your Name (if you are the trainee, still enter YOUR name) *

First Name

Last Name

Date of Training *

MM

DD

YYYY

Shift Worked *

Day

Night

Both

Clock-In Time *

Fill out each box (for seconds you may use 00)

Hour

Minute

Second

AM PM

Clock-Out Time *

Fill out each box (for seconds you may use 00)

Hour

Minute

Second

AM PM

What was the result of today's training? *

No change in ability

Minor improvement

Moderate improvement

Remarkable improvement

What is the trainee's ability on the FOUNTAIN? *

1-Cannot perform the task

2-Familiar with the Idea(s)

3-Can perform with help

4-Can perform alone

5-Can perform alone with efficiency and speed

6-Can teach others

N/A Has not trained on this task

N/O Not observed during training session

What is the trainee's ability on the WINDOW? *

1-Cannot perform the task

2-Familiar with the Idea(s)

3-Can perform with help

4-Can perform alone

5-Can perform alone with efficiency and speed

6-Can teach others

N/A Has not trained on this task

N/O Not observed during training session

What is the trainee's ability on the MACHINES? *

1-Cannot perform the task

2-Familiar with the Idea(s)

3-Can perform with help

4-Can perform alone

5-Can perform alone with efficiency and speed

6-Can teach others

N/A Has not trained on this task

N/O Not observed during training session