Competency Record FormCompetency Record. THIS FORM MUST BE COMPLETED AT THE END OF TRAININGSpeak to your trainer for more informationDetailsFirst NameSurnameDateTrainer- Select -Blen Tohianga SimeonM P ChaseDan RiversCourse- Select -Licence to operate a forklift truck - TLILIC0003Working At Heights - RIIWHS204ELicence to erect, alter and dismantle scaffolding intermediate level - CPCCLSF3001Enter and work in confined spaces - RIIWHS202EGas Test Atmospheres - MSMWHS217Construction White CardElevated Work PlatformAssessmentLocation Of Assessment 7/15 Vanden Way, Joondalup, 6027 14/2 Gott St, Port Kennedy, 6172Type of assessment RPL Work based Training OtherIf Other please specifyAssessor Comments- Select -Competent in all areasNot yet competentOtherIf Other please specifyActions to be taken: (e.g areas to be retrained and re-assessed)Learner Signature Sign HereSubmit Form
