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Company Name
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TABLES OF CONTENTS
Work Information
Department:
Title:
Employment Date :
Work Phone Number:
Work Email:
Contact Information
Phone Number:
Email address:
Address:
Education Information
Institution:
Year of graduation:
Specialisation:
Name
Phone Number
Address:
Email address:
Relationship
Employee signature :
Date
Address:
Email address:
Relationship:
2
Name
Phone Number
Address:
Email address:
Relationship:
If you have a chronic or serious medical condition you wish to tell us about, please also provide us
with your doctors contact in case of an emergency. This section is completely optional.
We would prefer to know how to help you if anything happens, however we also respect your choice
and privacy.
Doctors Name:
Phone Number:
I have voluntarily provided the above information and authorise [Company Name] and its
representatives to use them on my behalf in case of an emergency
Employee Signature
Date
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Leave Application
Employee Information
Name:
Department:
Date of leave : From / / To / /
Number of days:
Number of days
accrued:
Type of Leave
Employer signature :
Manager approval
Approved Rejected
Manager signature :
Date [Enter
Version
control]
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Work from Home Request
Name:
Department:
Title:
Description Request
Category
Approved Rejected
1 Year
1 2 3 4 5
No Yes
5 6 7 8 9 10
Hours
Do you need further equipment to improve your productivity? If so, what are
they?
Work Table
Chair
Monitor
Internet Upgrade
Table Lamp
Other .....................................................................
Total: $
Authorised by : Date :
Justification:
Total: $
Authorised by : Date :
Employee Name:
Title:
1. Have you had any of the following symptoms in the last 24 hours?
Y N
Cough
OR at least TWO
Shortness of the
of breath orfollowing symptoms in the last 24 hours:
difficulty breathing Y N
IfFever
you answered
(usually"YES"
38°Co or
question one,
100.4°F orplease DO NOT come into work. You should: Self
quarantine for at least 10 days from the date on which you first experienced any of the
higher Chills
above symptoms; AND wait until you have had no fever for at least 3 days (without the use
ofRepeated shaking
fever reducing with AND improved respiratory symptoms (no cough, shortness of
medication)
breath)
chills Muscle pain
Headache
In the last 14 days you have: Y N
Sore
If you answered 'Yes' to any part of question two (2), please DO NOT come into work. You
Been on contact with someone who was diagnosed with COVID-
throatself
should quarantine for at least 14 days.
19? Been on close contact with someone who had COVID-19
I certify to the best of my knowledge, this information is accurate.
symptoms? Traveled internationally or been on a cruise
Signature
Date
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Employee Complaint Form
Employee Name:
Date of Complaint:
Supervisor’s name
Describe how the incident you are complaining about has impacted
negatively on your work:
Give additional comments which you believe will be important during further
investigations of your complaint:
Supervisor’s comments:
By signing you declare that all information you have given here is truthful and accurate.
Employee signature
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Disciplinary Action Form
Date
To:
Employee Name:
Department:
Title:
From:
Employee Name:
Department:
Title:
This employee warning notice is being issued to you for [enter details],
specifically due to the following details:
[Example: Note any past verbal or written warnings received by the employee regarding their
performance/conduct, including emails, job description, training, or other evidence showing that the
employee was aware of his/her expectations.]
Date:
Action:
Supervisor:
Document:
[Example:On Date, you and Supervisor took the Action documented by the Document]
Category
Request Description
Employee signature
Date
Functional Expertise
Area and system expertise
Execution
Pursues all assignments and
projects until completion.
Follows through on
assignments to ensure
successful completion.
Courage
Confronts problems directly,
taking action and being
decisive. Does what is right for
the patient.
Customer Focus
Identifies customer needs and
executes to meet or exceed
customer expectations
Communication
Communicates effectively one-
on-one and in groups, while
openly sharing knowledge and
expertise
Adaptability
Responds resourcefully,
flexibly, and positively when
faced with new challenges and
demands. Moves forward
productively and optimistically
under conditions of change or
uncertainty.
Engagement
Commits to the mission, vision
and objectives of the
organization. Creates a sense
of energy by empowering
others and recognizing
performance.
Strategic Thinking
Demonstrates understanding
of mission, vision, and
strategies for business unit,
function or region. Maintains
the overall big picture of the
business and its
interrelationships
2. Please indicate the competency in which this individual most excels at,
and provide explanation as to why (specific examples are desired).
3. Please indicate the competency in which this individual should focus on to drive the
biggest impact to the organisation, and provide explanation as to why (specific examples
are desired).
4. What has this individual accomplished this year that has had the biggest
impact on you?
5. In what way(s) does this individual contribute to overall team objectives and goals?
Name:
Title:
Very Satisfied
Somewhat Satisfied
Neutral
Somewhat Dissatisfied
Dissatisfied
Salary
Overall benefits
Health benefits
Performance feedback
Employee evaluations
Recognition
Training opportunities
Opportunities for advancement
Yes
No
if No, please explain why?
Yes
No
If No, please explain why?
Yes
No
If No, please explain why?
Are sufficient efforts being made to solicit colleague opinions and feedback?
Yes
No
If No, please explain why?
Use the below to rate your experience with us. 1: Not Satisfied - 10: Total Satisfied
Feedback
Is there anything we could have done that would have change your decision to leave?
Yes No
Items to be returned
Information to be returned
Confidentiality Agreement
Non-compete Agreement
Remibursement of expenses
Loans