Professional Development Employee Training Record
Employee Name:
Employee Email Address:
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Training Date
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/
Month
/
Day
Year
Date
Presented/ Sponsored By:
*
Please Select
Aisha Evans, Director, CI
Chad Linn, VP of Compliance and Operations
Danny Bray, Sr. Director of Employment
Delaina Lipsey, Asst VP of Programs
Diane Gann, Director
Lanie Rodriquez, Manager
Omar Marshall, Manager
Philana Mertz, Manager
Shante Patterson, QSC
Susan Smith, Manager
Tammy McMiller, Manager
Velvet Hatcher, Manager
Other
Trainer Name:
Trainer Email Address:
J.Smith@MyNobleLife.org-- FirstInitial.LastName@MyNoblelife.org
Type of Training:
Position Requirement
TRAINING AGENDA
Transportation Procedures:
#1 “Transportation of Individuals Served (Agency and Personal Vehicles)
#2 “Use of Agency Vehicles
#3 “Automobile Related Accidents/Incidents
#4 “Maintenance of Agency Vehicles
#5 “Agency Vehicle Inspections
#6 “Distracted Driving
#7 “Use and Monitoring of Corporate Gasoline Credit Cards
#8 “Electronic Monitoring of Agency Vehicles
Pre-Trip Inspection
Using the Vehicle Pump
Securing a Wheelchair in the Vehicle Demonstration
Vehicle Repair Request
Mileage Sheet
Auto Accident Report
Vehicle Training Packet
I successfully demonstrated how to secure a wheelchair.
*
Yes
No
I successfully demonstrated how to secure an occupant.
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Yes
No
I am comfortable with my ability to properly secure a wheelchair and occupant independently.
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Yes
No
Title/Dept.
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Emp. #
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Time
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Duration
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Please Select
0.25
0.50
0.75
1.0
1.25
1.50
Location:
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Employee's Signature
*
Submit Completed form to Trainer
Copy: HR, Employee, Supervisor
Should be Empty: