Heavy Vehicle Driving Operations Skill Set Entry Evaluation Form
SP Title
Course details
Location
*
Broome
Derby
Fitzroy Crossing
Halls Creek
Karratha
Kununurra
Minurmarghali Mia (Roebourne)
Newman
Pundulmurra (South Hedland)
Tom Price
Wyndham
Start date
*
-
Day
-
Month
Year
2 digit day, 2 digit month, 4 digit year
Applicant Details
Name
*
First Name
Middle Name
Last Name
Date of Birth
*
-
Day
-
Month
Year
2 digit day, 2 digit month, 4 digit year
Residential address
Street Address
Street Address Line 2
Town/City
State
Post code
Phone Number
*
Please enter a valid phone number.
Format: 0000 000 000.
Email
*
example@example.com
License details
Have you held a WA C Class Licence for at least two years? (must not be provisional)
*
Yes
No, less than 2 years
No, I don't have a C Class Licence
To enrol in this course, you must have held a C Class Licence for a minimum of 2 years.
Do you hold any of the below classes? (tick all that apply)
*
LR (Light Rigid)
MR (Medium Rigid)
HR (Heavy Rigid)
HC (Heavy Combination)
MC (Multi Combination)
None
Have you held your LR or MR Licence for more than 12 months to be eligible to upgrade to HR?
*
Yes
No
Have you held your LR Licence for more than 12 months to be eligible to upgrade to HR?
*
Yes
No
Have you held your MR Licence for more than 12 months to be eligible to upgrade to HR?
*
Yes
No
WA Driver's License Number
*
Expiry date
*
-
Day
-
Month
Year
2 digit day, 2 digit month, 4 digit year
Are there any conditions listed on your Driver's Licence?
*
Yes
No
Please list the condition/s
*
Please upload a copy of the FRONT of your WA Driver's Licence
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Please upload a copy of the BACK of your WA Driver's Licence
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Do you hold a Forklift High Risk Work Licence?
*
Yes
No
Forklift High Risk Work Licence Number
*
Expiry
-
Day
-
Month
Year
2 digit day, 2 digit month, 4 digit year
Further information
Have you undertaken work that required you to drive any heavy vehicle?
*
Yes
No
Which class/es?
*
MR
HR
Other
How much time have you spent driving truck(s) you hold licence(s) for?
*
Less than 400 hours
400 to 2,000 hours
More than 2,000 hours
Do you have capacity to attend all components of the training program for the full 8 units over 6 weeks? (Participation in all units is a pre-requisite for enrolment in the Heavy Vehicle Driver training)
*
Yes
No
Are you currently employed?
*
Yes
No
Is your job in the transport industry?
*
Yes
No
Does your employer know about your enrolment in this program?
*
Yes
No
Does your employer support your enrolment in this program?
*
Yes
No
Literacy
Do you understand there are a number of assessment components which you have to complete including written and practical assessments?
*
Yes
No
How would you describe your written language skills?
*
Poor, need some help with detailed writing
Average, can write work related documentation
Good, can manage all kinds of written documents
How would you describe your mathematics skills?
*
Poor, need some help with basic operations
Average, can complete most math and calculation problems
Good, can manage all math and calculation problems on my own
How would you rate your ability to use computers for routine work-related activities?
*
Poor, need some assistance
Average, can manage most work tasks
Good, can use all kinds of computer programs
If you enrol in the program, would you like to receive assistance to help with written, math or computer work tasks?
*
Yes
No
Eligibility Checklist
Please tick to confirm you meet the below requirements
*
I am fit and able to pass a Heavy Vehicle Drivers commercial medical
I can routinely pass drug and alcohol screening
I have no suspensions or outstanding fines/matters that will impede an application for a truck licence
I can comply with conditions for practical driving training, assessment and licencing
I can comply with conditions for Forklift High Risk Work Licence Training and Assessment
Submit
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