This form is designed for units to request Region L&D to approve high risk physical assessment activities such as Pack Hike & Swim Tests as well as request attendance at Units for skills maintenance sessions.

This form must be submitted at least 21 days prior to the commencement of the activity and where applicable ensures compliance with RTO, Safety & Quality Assurance obligations.

Unit *

Region

UST

First Name *

Last Name *

Email Address *

Phone *

Unit Email

LD Email

Emergency Management Region

East Region Cert IV or Truck Licence

Cert IV TAE nominationTruck Licence nomination

*** Preference is for Unit to Pay for the Truck Licence or TAE Cet IV, Region may reimburse units through cost savings of the Regional Training Budget. Submit this form and speak to your OM - L&D for more info***

NOTE: Your site safety Plan & Risk Assessment documentation can be uploaded later in this form or you can request assistance if needed.

Other - Request

Training Aide Request

Training boatWater Rescue DummyCar Trailer

Full name of member applying *

Mobile # of nominated member *

Email *

Length of Service *

Select the Skill *

Other request *

NOTE: The Course you have requested will have to be conducted by a staff member or external provider

How many members will attend this activity *

Are you happy for other members from other units to participate in the activity *

YesNo

What delivery format would you like to use for this activity? *

OnlineFace to FaceEquipment booking

External Agencies

YesNo

Select the Start date of your proposed activity *Course date MUST be at least 21 days from today to ensure approval

When will you return the equipment

Select the assessment date of your proposed course *

Name of the driver towing trailer *

I understand the anchor points on the trailer are not rated and should not be used *

I understand the Unit will be liable for any damage to the vehicle during the rental period *

WI602 Trailer Hitching Process

WI605 Vehicle Carrying Trailer

I have read and understood the Work Instructions above *

Do you have an endorsed Trainer & Assessor for this course at your unit?

YesNo

Would you like Region to source a Trainer or Assessor for you?

YesNo

Select what you would like Region to find for you.

TrainerAssessor

Please list the name/s of the Endorsed Assessor/s you will be using to assess this course

Please list the name/s of the Trainer/s you propose to use to deliver this course

Do you have all the equipment & Training materials to deliver the course?

YesNoUnsure

Please list the additional equipment you require to deliver this course

Required Documentation

Do you need assistance in developing Risk Assessment & Site Safety Plans *

YesNoUnsure

Risk Assessment

A Risk Assessment is required for your chosen activity. You can find a generic risk assessment for your training activity on the Hub under the relevant course in the courses & qualifications page or download a blank assessment from Section 3.2 of the Training & Assessment Procedures Manual in the Training Portal.
Simply add any local specific detail and submit below.

Upload your Administrative Risk Assessment

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Site Safety Plan

A Site Safety Plan is required for your chosen activity. You can find a Site Safety Plan Section 3.3 of the Training & Assessment Procedures Manual in the Training Portal.
Simply add any local specific detail and submit below.

Upload your Site Safety Plan

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