Vinnies Van Volunteer Information Request

First Name: …………………………………..Surname:……………………………………………….

Address:……………………………………………………………………………………………………

…………………………………………………………. Postcode: ……………………………………..

Home Phone: …………………………… Mobile Phone: ……………………………………

Email Address: …………………………………………………………………………………..

Date of Birth: ………………………………

(Please Circle an option)

Frequency of Outings: Weekly/Fortnightly/Monthly/Every two months/Other ………………

Night Available: Monday/Tuesday/Wednesday/Thursday/Friday/Saturday/Sunday

Do you wish to be on the Back-Up Team? YES/NO If YES…What Night? …………………….

Would you like to be a Driver (Automatic Hi-Ace Van)? YES/NO

If YES...

Licence Number: ………………………………. Licence Class: …………………………….

Person to Contact in case of Emergency:

Name: ………………………………………………………

Address: …………………………………………………..

Phone: ………………………………………………………

Have you any previous mobile food van experience? YES/NO

If yes, where & when? ………………………………………………………………………………………………………………………

………………………………………………………………………………………………………………………

Do you have a Current First Aid Certificate? YES/NO Expiry Date: ……………………………..

I agree to abide by the terms outlined in the Operation Manual Summary for Vinnies Van as amended – current copy available in Vinnies Van.

Signed: ……………………………………………….. Date: …………………………………………….

All information will be kept strictly confidential and is for Vinnies Van Use ONLY.