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Address: 4G Brook Street, Parkvale Tauranga 3112
Email: office@taurangafoodbank.co.nz
Phone: 07 578 9888

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1Personal Details

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3Driver Insurance

4Safety & Security

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Personal Details

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Driver Insurance

Answer the following questions if you would like to be a van driver:

This information is required by State Insurance and will not be shared with anyone else.

In the last 5 years have you had any accidents or losses involving damage to or theft of a vehicle?*

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Please provide details*

In the last 5 years have you had any license cancelled or suspended or had any special conditions imposed?*

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In the last 5 years have you had any driving offenses or traffic infringements excluding parking offenses?*

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In the last 5 years have you had any insurance refused or cancelled, renewal not offered, claim refused or any special conditions imposed?*

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In the last 7 years have you been convicted of a criminal offense relating to fraud, theft or burglary, arson, or criminal or wilful damage?*

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Please provide details*

If you answered "yes" for any of the above questions, we ask that dates and offense details be provided. For example, if it is a speeding fine, how many km's over the limit, what the fine amount was if known, and the penalty (fine, demerits, suspension).

Driver's License Number*

Safety & Security

Have you been convicted (or currently involved with an investigation) of any criminal offense or serious traffic offense (other thank parking fines)?*

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No

Do you give consent for Tauranga Food Bank to run a police check?*

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No

Do you have a current New Zealand driver's license?*

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Are you able to drive a manual van?*

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Do you have any health concerns that Tauranga Food Bank need to be aware of?*

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I confirm that the above information I have provided is correct and that I will only use the van as instructed by the Tauranga Community Food Bank Staff and Trustees.

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About Us
Food Support
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- Schools’ Appeal
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Contact Us

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That everyone in our community has access to sufficient, nutritious kai.

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4G Brook Street, Parkvale
Tauranga 3112

office@taurangafoodbank.co.nz

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