DUBA GREEN INTEGRATED SOLAR COMBINED

CYCLE POWER PLANT

SEC/ISCCPP/CIS/HSE/126 ID REQUEST FORM Rev 01

PERSONAL DETAILS OF APPLICANT/REQUESTOR

Company Name: Date:
Applicant Name: Sponsor Company:
Nationality: Job Title:
Passport No.: Expiry Date:
Iqama No.: Expiry Date:
Date of Birth: Blood Type:
APPLICANT’S PROJECT MANAGER / SITE MANAGER VERIFICATION/APPROVAL
Signature:
Name: Date:
CIS APPROVAL
CIS PROJECT MANAGER / SITE MANAGER
Signature:
Name: Date:

CIS SECURITY MANAGER VERIFICATION/APPROVAL

Legal status has been checked and approved Signature:
Name: Date:

CIS HSE INDUCTION TRAINER

Attended the basic Safety Orientation Signature:
Name: Date:

CIS MEDICAL EVALUATION

The Person is fit for specified job position at project site Signature:
Name: Date:
Processed by: ID Number
Signature: Date: Expiry date:

ATTACHEMENTS
 Iqama / Passport Copy  Blood group
 Medical Insurance Card copy  Statement Letter (If not own employee)
 Medical Report copy  Photograph (Passport Size)

ID REQUESTER/RECEIVER DECLARATION
I am hereby ensuring that the information and data given above is correct Date:
Name: Signature: