BOILERMAKER APPRENTICE EVALUATION REPORT - To be completed by:

Your Position Your Position Co-worker Steward Foreman General Foreman Supervisor

Date

Employee #

Apprentice Local Lodge #

Name of Apprentice

Last Name

Employer Name

Evaluator's Name

Job Location

Employment Date From

Employment Date To

# of Hours Worked

Type of Project Type of Project Construction Maintenance Demolition Shop

Duties Duties Burning Blueprint Reading Confined Space Watch Fiberglass Fitting Grinding Layout Metalizing Rigging Tack Welding Tube Expanding

EVALUATION - Rank on a scale of 1 - 5 (1)=Poor (5)=Excellent

Type of Work Type of Work Bins & Hoppers Boilers Cement Plant Condensers / Evaporators Digesters Gas Plant Heat Exchangers Nuclear Power Plant Penstock Precipitator Pressure Vessel Refinery Scroll Casing Scrubbers Stacks and Breeching Tanks

Attitude to Job Attitude to Job 1 2 3 4 5

Attitude to Safety Attitude to Safety 1 2 3 4 5

Initiative Initiative 1 2 3 4 5

Attitude to Co-Workers Attitude to Co-Workers 1 2 3 4 5

Overall Rating Overall Rating 1 2 3 4 5

Capability Capability 1 2 3 4 5

ATTENDANCE

Absent Absent Never Often Rarely

Late Late Never Often Rarely

# of times absent (If never enter 0)

# of times late (If never enter 0 )

Evaluator's Comments:

Evaluator's Name

Signature By filling out your name, you agree your electronic signature is the legal equivalent of your manual signature.

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