IUOE Local 955 Apprenticeship & Education follows strict COVID-19 virus prevention procedures and responsibilities. These have been developed in accordance with federal
and provincial public health recommendations and IUOE Local 955’s best practices. As such, these procedures may change as the pandemic evolves. This Risk Exposure
Declaration is part of our procedure and every student who attends a course is required to complete and submit this document when confirming attendance and again
during the course orientation.
Please read and answer all of the questions below.
Yes (Check all that apply below): No
Shortness of Breath
If yes, please provide test date/expected result date: ________________________.
If you have been diagnosed with COVID-19, are awaiting a test result, or answered “yes” to any of the other above questions, you will not be permitted to attend a training course at this time.
You are also required to contact Alberta Health Services and complete the self-assessment. Please note that by signing this form, you are agreeing to disclose future potential illness or exposure to COVID-19 that may have or will occur during the time you are participating in training.
Please complete your contact information below:
Print your name: _________________________________
Employer name: _________________________________
Best way to contact you: text______________________________ OR email______________________________________
Your signature: ___________________________________