BOILERMAKER APPRENTICE EVALUATION REPORT - To be completed by the Supervisor

Date

Employee #

Apprentice Local Lodge #

Name of Apprentice

Last Name

Employer Name

Supervisors Name

Job Location

Employment Date From

Employment Date To

# of Hours Worked

Type of Project Type of Project Construction Maintenance Demolition Shop

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

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

Attitude to Safety Attitude to Safety 1 2 3 4 5

Attitude to Job Attitude to Job 1 2 3 4 5

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

Initiative Initiative 1 2 3 4 5

Capability Capability 1 2 3 4 5

Overall Rating Overall Rating 1 2 3 4 5

Absent Absent Never Often Rarely

Late Late Never Often Rarely

# of times absent

# of times late

Supervisors's Comments:

Supervisor's Name

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

Email A copy of this completed form will be emailed to you for your records.