INDUCTION FORM
Visitor
Name of person completing induction form:
First Name
Last Name
Name of company:
Company name of person completing induction form.
Email Address:
example@example.com
Mobile Number:
-
Area Code
Phone Number
Reason for completing induction form:
Reason for completing induction form.
Who at Egoli gas are you meeting:
Name of person your meeting is scheduled with.
When will you be visiting Egoli gas:
-
Month
-
Day
Year
Date
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
1) Are firearms allowed on the Egoli Gas premises?
*
YES
NO
2) Where should all visitors wait until their host arrives?
*
Security Gate
Reception Area
Their Motor vehicle
3) What option below is not part of the 3-point contact rule?
*
Keep one foot grounded
Keep both hands on handrail
Keep your eyes on the path
Keep one hand on the handrail
4) Who should you take guidance from in case of an Emergency alarm sounding 3 consecutive times?
*
Your Egoli Gas host
SHE Representative
Safety Office
5) Where is the evacuation assembly area on the premises?
*
In the reception area
Maintenance department
In the parking at the Main Entrance
Security
6) Where should you return your visitors access card to?
*
The receptionist
Your host
Security
Signature
*
Submit
Should be Empty: