GDL2MAHI

Tairawhiti REAP invite you to complete this survey to be considered for our GDL2MAHI program. Assisting whanau to obtain their driver's license and connecting whanau to mahi from Potaka to Uawa and Gisborne Rural Areas.

There is a $80 bond payment to participate in the program. This fee includes 2 FREE driving lessons and your driving test fee. More information provided once registration has been completed.

Please ensure you answer these questions in full, failing to do so could delay your application. Any questions please text Arlu (East Coast) on 022 0769 704 or email arlu@tairawhitireap.org.nz or Helen (Gisborne Rural) 021 022 57046 or email helen@tairawhitireap.org.nz

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* 1. What is your first name?

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* 2. What is your last name?

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* 3. Please provide your contact details below

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* 4. What is your date of birth?

Date

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* 5. b'What is your gender?'

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* 6. What is your ethnicity? (Select all that apply)

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* 7. What age range are you:

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* 8. Where do you LIVE?

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* 9. What type of driver's licence do you currently hold?

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* 10. How confident are you as a driver?

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* 11. What is your licence number (this is on the front of your licence)? If you don't have a licence, type NA

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* 12. What is your licence VERSION number (this is either on the front or back of your licence - it has 3 numbers eg 458). If you don't have a licence type 000

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* 13. What is your licence EXPIRY DATE? You'll find this on the back of your licence. If you don't have a licence put in today's date

Date

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* 14. What barriers have stopped you from progressing towards your Restricted or Full licence in the past? (Please select all that apply)

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* 15. Do you have any driving offences or other barriers that may stop you from gaining your licence?

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* 16. If you answered NO, Please type no offences. If you answered YES, could you briefly describe what these offence are, so we are able to help you overcome these issues.

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* 17. Do you prefer an automatic or manual car?

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* 18. Are you currently receiving a benefit? This info helps us to inform MSD of the need that exists. 

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* 19. If you are receiving a benefit please enter you CLIENT NUMBER. 
Not providing your client number may delay your registration.

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* 20. If you are receiving a benefit, which do you receive?

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* 21. Are you employed?

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* 22. Do you have any appointments or holidays coming up in the next 3 months. Please advise dates that you are unavailable.

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* 23. I understand that there is a $80 bond payment to participate in the GDL2MAHI program

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* 24. I understand that this fee is non-refundable and if i fail to attend scheduled appointments, my bond payment could be forfeited

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* 25. GDL2MAHI is more than just a driver licence program.
The program requires commitment from the participants to engage with our team to improve their current work/training and career pathways.

We can assist you into further training, preparing a resume, submitting employment applications and more.

You will receive a information pack outlining the full program outline and process within 7 days of completing the survey.

Thank you for completing the survey. One of our staff will be in touch with you to confirm your information and registration.
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