Physical Requirements:

Write % next to description

Ability to stand _________

Ability to crawl ________

Ability to walk _________

Ability to reach ________

Ability to sit __________

Ability to handle _______

Ability to stoop ________

Ability to finger _______

Ability to kneel ________

Ability to feel _________

Ability to crouch _______

Ability to speak ________

Ability to hear _________

Ability to lift (X) lbs. _________

Ability to carry (X) pounds _______

Ability to push (X) lbs. _________

Ability to pull (X) pounds _______

Ability to ascend (X) ft. ________

Repetitive motion ________________

Eye/Hand coordination ____________

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