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INDIANA DEPARTMENT OF TRANSPORTATION <br />ECONOMIC OPPORTUNITY DIVISION <br />100 North Senate Avenue <br />Room N750 <br />Indianapolis, Indiana 46204-2216 <br />Telephone: (317) 233-2412 Fax: (317) 233-0891 <br />Troll nlrovdilrodotr2'753jitm <br />QUARTERLY OJT TRAINEE REPORT <br />1. <br />ContractorNamet <br />Name of Trainee: <br />2, <br />Sex 3, Racial/Ethnic Identification (Check One or More): <br />El Male Female El American Indian or Alaska Native Asian El Black or African American <br />[I Hispanic or Latino Native Hawaiian or Pacific Islander <br />White <br />Performance Ratings: (1, 2, 3 = Poor Performance) (4, 5, 6, 7 = Average Performance) (8, 9, 10 <br />= Excellent Performance) <br />4. <br />Attendance: <br />L 2. 3, 4, <br />5. 6 7, <br />8. 9. 10, <br />5. <br />Attitude toward co-workers & employer: <br />1. 2 3, 4. <br />5. 6. 7. <br />8. 9, 10, <br />6. <br />Job Knowledge: <br />1. 2. 3, 4. <br />5. 6 7, <br />8. 9. 10. <br />7. <br />Use of time: <br />1. 2. 3. 4, <br />5, 6. 7, <br />8, 9, 10. <br />S. <br />Handling of tools, equipment& material: <br />1. 2, 3, 4 <br />5, 6. 7. <br />8, 9. 10. <br />9. <br />Observance of safety rules: <br />1. 2. 3. 4, <br />5, 6, 7, <br />8, 9, 10, <br />10. <br />Professional Appearance/Preparedness <br />1. 2. 3. 4. <br />5, 6. 7. <br />8. 9, 10, <br />11. <br />Overall Ability: <br />L 2. 3, 4. <br />5. 6. 7. <br />8. 9 10, <br />12. <br />Comments: <br />13. <br />PREPARED BY: Signature and Title of Contractor's Representative <br />14. Date: <br />