ISEM01 - Protective Clothing Requisition Applicant Details Name*This field is required. * Required Field. Address*This field is required. * Required Field. Telephone Number Alternate Contact Number Email Address*This field is required. * Required Field.* Please enter a valid email address. Name of Brigade Select an Option Cape Burney BFB Casuarinas BFB Eradu BFB Moonyoonooka BFB Mullewa Central BFB Mullewa South BFB Pindar-Tardun BFB Tenindewa BFB Waggrakine BFB Walkaway BFB Equipment Officer/Captain*This field is required. * Required Field. Individual Requirements I am;*This field is required. Select an Option a New Member Replacing an Existing Item * Required Field. Standard Sizing 1/2 Face RespiratorFull Face RespiratorGlove ClipGooglesHelmetHelmet Torch and BracketKit Bag Boots (Lace-Ups) Sizes: Select an Option 6 6.5 7 7.5 8 8.5 9 9.5 10 10.5 11 11.5 12 12.5 13 13.5 14 Cargo Pant Sizes Select an Option 77 79 82 84 87 92 97 102 107 112 117 122 127 132 Glove Sizes Select an Option S (Small) M (Medium) L (Large) XL (Extra Large) 2XL (Two-Extra Large) Pant Sizes Select an Option 77 79 82 84 87 92 97 102 107 112 117 122 127 132 Sunglasses Select an Option Bolle PPC Select Top Coat/Jacket Sizes: Select an Option 77 79 82 84 87 92 97 102 107 112 117 122 127 132 T-shirt Sizes (Qty 2): Select an Option S (Small) M (Medium) L (Large) XL (Extra Large) 2XL (Two-Extra Large) 3XL (Three-Extra Large) 4XL (Four-Extra Large) Wide Brim Hat Sizes: Select an Option S/M L/XL 2XL/3XL Special Orders You may need to do a Special Order for certain items; If your Boot size is outside the specified sizes - please specify your size in the Notes section. Overalls are available on request, please specify your size in the Notes section. Notes Protective Clothing/Equipment Guidelines All Protective Clothing and Equipment belongs to the City of Greater Geraldton and upon resignation all issued items must be returned to the City of Greater Geraldton Cheif Bush Fire Brigade Control Officer (CBFCO) and not to the Brigades. This is for reassessment to be either reassigned or disposed of. All Protective Clothing will only be replaced on a wear and tear basis and must always be kept in a clean and tidy condition. Personal Protective Clothing that has been lost or damaged due to neglect, the person responsible for the item maybe held liable to either replace the item or pay for the item. Faulty Protective Clothing must be reported as soon as possible, to either your Captain or your Equipment Officer. I have agreed to submit this application by electronic means. I can confirm that the information given in this application is true, complete and accurate. By checking this box and typing my name below, I am electronically signing my application.*This field is required. Please tick here Signature*This field is required. * Required Field. The City of Greater Geraldton collects the personal information you provide in relation to the Protective Clothing Requisition form so we can deliver the service, process your request, and meet our legal obligations under the Local Government Act 1995 and any other related legislation. Your information may be shared with government agencies, contractors, or others where authorised by law or with your consent. Where required by law, your personal information will be made publicly available, e.g. public registers. The City manages personal information in accordance with relevant privacy legislation and takes reasonable steps to protect it from unauthorised access or disclosure. You may request access to, or correction of, your personal information by contacting the City at privacy@cgg.wa.gov.au. Type the code from the image: The code you entered is not valid. Get Audio CodeType the code from the image Was this page helpful? How can we improve this page? Email Address*This field is required. * Required Field.* Please enter a valid Email Address Type the code from the image: Do not fill this textbox.