Working Alone Notification Sign Out

Complete this sign out form when you have finished your work or study and are leaving campus, or as soon as possible afterwards. When you submit this form an email notification will be sent to your supervisor/instructor informing them that you are leaving or have left the campus.

Sign out survey

Name * Required
First Last
BCIT Email * Required
Instructor/Contact/Supervisor/Manager Name * Required
First Last
Instructor/Contact/Supervisor/Manager Email * Required
Are you leaving campus (or finishing your work-from-home shift) now? * Required
- Yes
- I left earlier but didn't fill out this form
Date of your visit to campus / work-from-home shift * Required
MM slash DD slash YYYY
When did you leave campus (or finish work, if working from home)? * Required

: Hours

Minutes

AM/PM AM/PM
Confirm you are not a robot
Privacy Notice: Your personal information is being collected under the authority of Section 26(c) of the Freedom of Information and Protection of Privacy Act and British Columbia’s Occupational Health and Safety Regulation. Your personal information will be used by BCIT Safety, Security and Emergency Management (SSEM) to provide a safe and secure campus environment, and in aggregate form that is not-personally identifiable for statistical purposes. If you have questions regarding the collection of personal information, please contact: Anna Matheson, Manager, Health, Safety and Environment, BCIT, 3700 Willingdon Avenue, Burnaby, B.C., V5G 3H2, or email amatheson10@bcit.ca.