Availability Request
LSV Flood Support
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
DOB
-
Day
-
Month
Year
Date
Club:
*
How long (time) does it take you to drive to LSV (200 The Boulevard Port Melb)?
*
What current awards/qualifications do you hold?
*
Bronze Medallion
Silver Medallion Beach Management or Patrol Captain
CPR (HLTAID009)
First Aid (HLTAID011)
RWC Operator Certificate
Advanced Resus Techniques (HLTAID0015)
IRB Crew
Silver Medallion IRB Driver
Remote Pilots License
What roles are you interested in fulfilling
*
Group Operations
Brief summary of operational experience (including any roles in emergency management in or outside lifesaving):
Are you available Thursday, 20 October 2022 (0700 - 1900)
Yes
No
Are you available Friday, 21 October 2022 (0700 - 1900)
Yes
No
Are you available Saturday, 22 October 2022 (0700 - 1900)
Yes
No
Are you available Sunday, 23 October 2022 (0700 - 1900)
Yes
No
Are you available Monday, 24 October 2022 (0700 - 1900)
Yes
No
Are you available Tuesday, 25 October 2022 (0700 - 1900)
Yes
No
Are you available Wednesday, 26 October 2022
Yes
No
Are you available Thursday, 27 October 2022
Yes
No
Are you available Friday, 28 October 2022
Yes
No
Are you available Saturday, 29 October 2022
Yes
No
Are you available Sunday, 30 October 2022
Yes
No
Are you available Monday, 31st October 2022
*
Yes
No
Are you available Tuesday, 1st November 2022
Yes
No
Are you available Wednesday, 2nd November 2022
Yes
No
Are you available Thursday, 3rd November 2022
Yes
No
Are you available Friday, 4th November 2022
Yes
No
Are you available Saturday, 5th November 2022
Yes
No
Are you available Sunday, 6th November 2022
Yes
No
For Ground Crew only
Regional deployment (overnight deployment)
Based on availability above, are you available to be deployed regionally with accommodation for multiple shifts (4 days preferably in a row)?
*
Comments around availability:
Please detail your employment commitments outside of your availability provided to help us manage fatigue - please outline what you do for employment:
*
Do you have work commitments 2 days prior and/or 2 days post deployment (explain)?
*
Do you need a letter of Emergency Service Deployment to provide to your employer?
*
Yes
No
Are you 'fit for work'? Please advise any pre-existing medical conditions or injuries?
*
Submit
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