Laser Worker Registration Form (LWRF) - Swansea University

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Previous Experience
Prior to coming to Swansea University have you been involved in any work with lasers in any
capacity? YES / NO
If the answer is YES please give details of the work location and your status there, the nature of the
work, the type of laser, details of any training received and the period of work in reverse chronological
order.
Use rear of sheet to continue
Declaration and signature of applicant:
I have read the CVCP booklet ‘Safety in Universities Part 2:1 Lasers’ and the list of precautions for
current laser classifications. I have also read and understand the local rules for laser work and agree
to abide by the requirements of these documents and fully understand the implications for my work.
Signed:
Date:
Declaration and signature of the supervisor:
The applicant will not be allowed to begin practical work with this laser class until this declaration has
been completed. I am satisfied that preliminary instruction and training on the hazards associated with
working with lasers has been given. I am satisfied that the applicant will receive hands on practical
training during the initial stages of the practical work post-registration.
Signed:
Date:
john.davies Page 2 09/08/2005