AR Handbook – 99
Driving Record (if you use vehicle on job)
Number of accidents on job: _____________________
Date of most recent accident: _____________________
Number of tickets on job: ________________________
Date of most recent: ____________________________
Disciplinary action taken by Board:
_____________________________________________
_____________________________________________
_____________________________________________
_____________________________________________
Work Record:
Commendations/Awards
(job-related & personal/use extra sheet if needed)
_____________________________________________
_____________________________________________
_____________________________________________
_____________________________________________
Disciplinary action taken ________________________
Reason: ______________________________________
Nature/type of discipline: ________________________
Date action taken: _____________________________
Key Community Services on Job: (Examples: Assisting police,
reporting fire evacuations, Townwatch, lost children,
reporting accidents, etc).
_____________________________________________
_____________________________________________
_____________________________________________
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