Name of Employee: _____________________
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Department: _________________
Human Resource’s Responsibility
Prior to Orientation
Organization and Employee Policies & Procedures
___ History of XYZ Inc.
___ Organization Chart
___ Purpose of the Company
___ Employee Classification
Insurance Benefits
___ Group health plan
___ Disability insurance
___ Life insurance
___ Workers’ compensation
Other Benefits
___ Holidays
___ Vacation
___ Jury and election duty
___ Funeral leave
___ Health Services
___ Professional discounts
___ Child care
End of Orientation- First Day
___ Make appointment for second day
___ Introduce supervisor
Other Items
___ Job Posting
___ Bulletin Boards
___ Safety
___ Alcohol/drug use
___ Where to get supplies
___ Employee’s records and updating
Policies and Forms
___ Form W-4 Completed
___ Form I-9 Completed
___ Emergency Information Form Completed
___ Employee Handbook distributed and reviewed
___ Employee Handbook acknowledged form
___ Health Care and Optional Benefits Form and information completed
___ No harassment form acknowledged
___ Informed on Confidentiality form
___ FMLA reviewed
___ Equal Employment Opportunity
Supervisor’s Responsibility
Employee’s First Day
General
___ Introduction to coworkers
___ Tour of department
___ Tour of company
Location of
___ Coat closet
___ Restroom
___ Telephone for personal use and policy
Working Hours
___ Starting in Leaving
___ Lunch
___ Breaks
___ Overtime
___ Early Departures
___ Timeclock
Pay Policy
___ Pay Period
___ Deposit System
Other Items
___ Parking
___ Dress
Employee’s Second Day
___ Pension Retirement Plan
___ Sick Leave
___ Personal Leave
___ Job Postings
___ Confidentiality
___ Complaints and Concerns
___ Termination
During Employee’s First Two Weeks
Emergencies
___ Medical
___ Power Failure
___ Fire
At the end of the employee’s first two weeks, the supervisor will ask if the employee has any questions concerning any items. After all questions have been discussed, both the employee and the supervisor will sign and date this form.
____________________
Employee’s Signature
___________________
Date
___________________
Orientation Conducted By