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Training Plan Name: Identification** Email: Course (course #) Date Trained Student Signature Instructor Signature* *Instructor Signature: By my signature I certify that the individuals on this roster
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Duct ID Date Trained Student Signature Instructor Signature By my signature I certify that the individuals on this roster have successfully passed the course (assessment). Identification Number: Enter your Employee ID, Student ID, UCR Fetid, or Date of Birth. Instructions: Submit this form to EHOS Training by campus mail, fax, or email eh straining UCR.edu Page 2 Training Plan Name: Janette Duct Identification Email: Janette Duct ID Date Trained Student Signature Instructor Signature By my signature I certify that the individuals on this roster have successfully passed the course (assessment). Identification Number: Enter your Employee ID, Student ID, UCR Fetid, or Date of Birth. Instructions: Submit this form to EHOS Training by campus mail, fax, or email eh straining UCR.edu Page 3 Training Plan Name: Janette Duct Identification 123456789 Email: Janette Duct ID Date Trained Student Signature Instructor Signature By my signature I certify that the individuals on this roster have successfully passed the course (assessment). Identification Number: Enter your Employee ID, student ID, or UCR Fetid number. Instructions: Submit this form to EHOS Training by campus mail, fax, or email eh straining UCR.

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