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;-- U - Training Record Form T rmNo. <br /> RN 04F <br /> Training Course: /� Lesson Plan Rev.: <br /> Qualified Trainer: ��. , 4r\ � r � Training Date: ' <br /> Employee Name: FffmtoYM-#: Employee Signature(~) Trainer <br /> s / <br /> Initials(2) <br /> 1 <br /> A signature in this column indicates that the trainee acknowledges taking this course. <br /> An initial in this column indicates that the Qualified Trainer acknowledges that the trainee has participated in the course and has <br /> passed the test. <br /> Rev. 0 (March 23,2015) <br /> Approved by: Allen ArmstroU Page 1 of 1 <br />