EmailMe Form - VOLULNTEER DRIVER SUPERVISOR REGISTRATION FORM

Name

First Last

Other names

Date of Birth

DD / MM / YYYY

Sex

Male

Female

Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country

Phone (BH)

Phone (AH)

Mobile

Email

Licence Number

Expiry Date

DD / MM / YYYY

EMERGENCY CONTACT DETAILS

Please supply details for 2 emergency contacts. These should be responsible adults who, for example, can assist you to travel if necessary

Name

First Last

Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country

Phone (BH)

Phone (AH)

Mobile

Name

First Last

Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country

Phone (BH)

Phone (AH)

Mobile

MANAGEMENT PLAN FOR PRE-EXISTING INJURY OR MEDICAL CONDITION

What is the medical condition

Allergy

Disability

Past injury

Other

Please provide details

INFORMATION ABOUT INJURY/CONDITION

How serious is the condition if aggravated?

How serious is the condition if aggravated?
Tick one or more boxes

Potentially life threatening

Could require own mediction

Could require rest or time off work

Could require medical (doctor, hospital) treatment

In your own words tell us how we recognise that your condition has recurred or been aggravated.

When was the most recent episode?

What actions, triggers or situations do you need to avoid?

What is the management plan to minimise any aggravation to the condition/injury?

E.g. Self medication, avoidance of allergy triggers (specify) etc

What is the emergency plan if serious aggravation does occur?

VOLUNTEER AVAILABILITY

Preferred Days

Preferred times

VOLUNTEER'S SPECIFIC NEEDS

Do you have any impairment or condition that could be aggravated by doing the tasks listed in the Job Description

Yes

No

JOB DESCRIPTION

TITLE

Volunteer Driving Supervisor

SUPERVISOR

The Manager and Program Coordinator

WORKS WITH

The Manager/Program Coordinator,
LEAP Coordinator,
LEAP participants,
Other volunteers.

EMERGENCY CONTACT DETAILS

MANAGEMENT PLAN FOR PRE-EXISTING INJURY OR MEDICAL CONDITION

INFORMATION ABOUT INJURY/CONDITION

VOLUNTEER AVAILABILITY

VOLUNTEER'S SPECIFIC NEEDS

JOB DESCRIPTION

TITLE

SUPERVISOR

WORKS WITH

DUTIES AND KEY RESPONSIBILITIES

Fill in log books

Include participants in the monitoring of oil, water and fuel levels before each use

Support participants

Deliver specified requirements as directed

Attend training days as scheduled

Assist participants to drive in a safe manner

Assist participants to complete driving hours

Maintain a safe work environment

Work to the policies and processes, guidelines and legislations

Maintain a positive working relationship as part of the team

Manage workload as directed

Maintain confidentiality

SKILLS REQUIRED

Ability to work as a part of a team

Ability to support staff and follow directions

Ability to assist with or present activities as directed

Patience and tolerance

Ability to be nonjudgemental

Willingness to work unsupervised

Ability to work within the guidelines and legislation appropriate to position

Common sense

Problem solving skills

Flexible, reliable, dependable and punctual

Ability to understand and to respect cultural difference

Agreeable to entering trial period

TRAINING REQUIREMENTS

Attend an initial induction and orientation session with Manager/Coordinator

Attend volunteer meetings

Gain an understanding of the needs of the LEAP participants

Attend relevant training days

Attend in-services as scheduled