Individual's Record of UBC Safety Training As long as you are working at UBC, you must keep this form updated. Contact Information Your Last Name, First Name Title (Mr/Ms/Mrs/Dr) Program (BS/MSc/PhD/PostDoc) PI/Research Supervisor Group Safety Representative E-mail Entry Date Departmental Phone Number Departmental Room Number Home/Cell phone Number Emergency Contact Info Mandatory Training RMS Chemical Safety Training: on-line RMS Chemical Safety Training: practical Chemistry Department Fire Extinguisher Training General Chemistry Department Training Research Laboratory-Specific Training TA Training (only for MSc and PhD) Bullying & Harassment Training RMS Training (if applicable) RMS Biosafety Training RMS Occupational First Aid Level 1 RMS LASER Training on-line RMS Radioisotope Training RMS Safety Committee Training RMS Lab Intro Training on-line RMS Floor Warden Training Course Specific TA Safety Training Chem 111/113 Chem 121/123/154 Chem 203/245 Chem 201 Chem 202 Chem 211 Chem 235 Chem 3XX Chem 445 Renewal Frequency 5 years once at UBC once at UBC 5 years recommended yearly once at UBC once at UBC Date(s) Completed Renewal Frequency 5 years 5 years 5 years 5 years 5 years 5 years 5 years Date(s) Completed Date(s) Completed Lab Director Initials