Eco Driver training form

• Site conducted

  Select

• Conducted on

  Date

• Prepared by

  Tonasz Ostrowski

  Haroldas Jelinskas
• Location
  Address

• Vehicle registration

• Vehicle type

• Drivers name

• Drivers licence number

• Expiry date

  Date

• Categories held

  Select AM A1 A2 A B1 B C1 C D1 D BE C1E CE D1E DE W

  • AM
  • A1
  • A2
  • A
  • B1
  • B
  • C1
  • C
  • D1
  • D
  • BE
  • C1E
  • CE
  • D1E
  • DE
  • W

VEHCILE CHECK

• Tyres

  OK

  UNDERINFLATED

  OVERINFLATED

  WORN EXESSIVELY

• TAX

  IN DATE

  EXPIRED

• INSURENCE

  IN DATE

  EXPIRED

• CVRT

  IN DATE

  EXPIRED

• Vehicle loaded?

  YES

  NO

  N/A

• Eyesight check

  ABLE TO READ PLATE AT 20 M

  NOT ABLE TO READ PLATE AT 20 M

• Pre drive preperation

  1

  2

  3

  4

  5

DRIVE 1 ASSESSMENT

• Acceleration (including cruise control)

  1

  2

  3

  4

  5

• Breaking (including engine brake/ exhaust brake/ retarder)

  1

  2

  3

  4

  5

• Clutch control

  1

  2

  3

  4

  5

• Gear selection and use

  1

  2

  3

  4

  5

• Hazard identification and prioritization

  1

  2

  3

  4

  5

• Use of speed (legal and appropriate)

  1

  2

  3

  4

  5

• Lane discipline and positioning

  1

  2

  3

  4

  5

• Judging roundabouts and junctions

  1

  2

  3

  4

  5

• Maintaining progress and planning

  1

  2

  3

  4

  5

• Use of mirrors and blind spots

  1

  2

  3

  4

  5

• Reaction to road markings, signs and traffic lights

  1

  2

  3

  4

  5

• Vehicle sympathy

  1

  2

  3

  4

  5

• Observation

  1

  2

  3

  4

  5

• Overtaking / meeting oncoming traffic

  1

  2

  3

  4

  5

Drive 2 assessment

• Acceleration (including cruise control)

  1

  2

  3

  4

  5

• Breaking (including engine brake/ exhaust brake/ retarder)

  1

  2

  3

  4

  5

• Clutch control

  1

  2

  3

  4

  5

• Gear selection and use

  1

  2

  3

  4

  5

• Hazard identification and prioritization

  1

  2

  3

  4

  5

• Use of speed (legal and appropriate)

  1

  2

  3

  4

  5

• Lane discipline and positioning

  1

  2

  3

  4

  5

• Judging roundabouts and junctions

  1

  2

  3

  4

  5

• Maintaining progress and planning

  1

  2

  3

  4

  5

• Use of mirrors and blind spots

  1

  2

  3

  4

  5

• Reaction to road markings, signs and traffic lights

  1

  2

  3

  4

  5

• Vehicle sympathy

  1

  2

  3

  4

  5

• Observation

  1

  2

  3

  4

  5

• Overtaking / meeting oncoming traffic

  1

  2

  3

  4

  5

• Odometer start (A)

• Odometer finish (a)

• Distance covered

• Start time

  Date

• Finish time

  Date

• Time taken (1)

• Gear changes (1)

• Fuel used - Litres /kWh (1)

• Litre- or kWh /100km (1)

• Take photograph of dash display

  Media

• Odometer start (B)

• Odometer finish (B)

• Distance covered

• Start time

  Date

• Finish time

  Date

• Time taken (2)

• Gear changes (2)

• Fuel used - Litres /kWh (2)

• Litre- or kWh /100km (2)

• Take photograph of dash display

  Media

• Difference in Time taken

• Difference in Gear changes

• Fuel saved (measured in litres)

• Fuel savings in Litres per 100km

• Instructor Notes