TAC L2P Learner Application Form

The Maroondah TAC L2P Program is currently at capacity, however we are still accepting applications from young learner drivers who want to take part in the program in 2020. 

 Please be aware that learner driver applicants need to meet the eligibility criteria outlined below.

• 16 - 21 years of age
• Live, work or study within the City of Maroondah
• Hold a current Victorian Learners Permit
• Make a commitment to the program for at least a 12 month period
• Have no access to a vehicle, and/or no access to a supervising driver, and/or limited financial means

If you meet the program eligibility as described above, and would like to apply for the program, please complete the Learner Driver Application Form below. We will contact you when there are vacancies to arrange an interview.  Thank you.

Please note we only have an automatic car.

TAC L2P Program - Learner Driver Application Form Does the young person (i.e. Learner Driver) meet the eligibility criteria outlined above? Yes
No To be eligible for the program you must have no access to a vehicle, and/or no access to a supervising driver, and/or limited financial means. Please give a brief description of why you think you would be eligible for the Maroondah TAC L2P Program: Person enquiring / referring (if applicable) First name Last name Job title (if applicable) Organisation (if applicable) Contact number Email address Young Person's Details First name Last name Date of birth Gender Street address Suburb Postcode Email address Home phone number Mobile phone number Learner Permit number Learner Permit expiry date Special License requirements? Is your Learner Permit subject to cancellation and/or suspension at this time? Yes
No Have you had any driving experience? Yes
No If yes, how many hours? Availability

	AM	PM	All day
Monday	AM	PM	All day
Tuesday	AM	PM	All day
Wednesday	AM	PM	All day
Thursday	AM	PM	All day
Friday	AM	PM	All day
Saturday	AM	PM	All day
Sunday	AM	PM	All day

Other Information Please provide any other relevant information e.g. primary language spoken, year of arrival in Australia (if applicable), etc Family living situation (in relation to having a suitable adult to teach, and access to a vehicle) What are some of your interests or hobbies? PRIVACY COLLECTION NOTICE Maroondah City Council is committed to protecting your privacy as prescribed by the Privacy & Data Protection Act 2014 and the Health Records Act 2001. The information you provide on this form is being collected by Maroondah City Council for the strict purpose of conducting Council business. Your information will not be disclosed to any external party without your consent, unless Council is required or authorised to do so by law. Failure to provide the information requested may make you ineligible to receive the service or be part of an event/function that is the subject of this form. Any access to the information, amendments that may be required or any privacy enquiries may be directed to Council's Privacy Officer & Health Records Officer on 9298 4211 or email - privacy@maroondah.vic.gov.au If you have any questions or any difficulty completing this form, please contact Youth Services on 9294 5723. Thank you!

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