Personal Emergency Evacuation Plan Name Staff Student Location Campus: Building: Floor and Room Number/s: Issue date Review date Have you practised the Emergency YES NO evacuation procedures? Type Further information assistance/equipment required for evacuation – Visual Hearing Mobility Other Personal evacuation procedures Staff/Student: Name Sign Date ………………………………………………. …………………………………………. ………………..…………… Emergency Warden: Name Sign Date ………………………………………………. …………………………………………. ………………..…………… A copy of this plan is to be held by both the PEEP owner and the relevant emergency warden.
Personal Emergency Evacuation Plan Name Staff Student Location Campus: Building: Floor and Room Number/s: Issue date Review date Have you practised the Emergency evacuation procedures? YES NO Type Further information – assistance/equipment required for evacuation Visual Hearing Mobility Other Personal evacuation procedures Staff/Student: Name ………………………………………………. Sign …………………………………………. Date ………………..…………… Emergency Warden: Name ………………………………………………. Sign …………………………………………. Date ………………..…………… A copy of this plan is to be held by both the PEEP owner and the relevant emergency warden.
Personal-emergency-evacuation-plan-template.docx