CAREER OPPORTUNITIES

Employment application form

Position Applied For

If Other, Please state

First Name

Last Name

Residential address

Postal Address (if different)

Mobile

Date Of Birth

Are there any restrictions on you taking up employment in Australia?

Yes

If Yes, Please provide details

Whom to notify in an emergency

Address

Phone

Relationship

We have a legislative requirement to provide a safe work environment and therefore need to know if you have any medical condition or disability that would preclude your ability to perform workplace duties. If ‘yes’ please state:

You need to inform us of any medication prescribed or unprescribed that you are taking or may take that may affect your capability or ability to perform workplace duties. If ‘yes’ please state:

Current Driving Licence

Yes

Class

Details of any Licence Conditions

State any Qualifications / Certificate of Competencies that could be relevant to the position (eg. White Card, Front End Loader, Grader, Forklift, Diesel Mechanic, First Aid etc.):

You may be required to produce documentary proof of your qualifications. Depending on work requirements you may be asked to work overtime and some weekend work. Does this pose a problem for you?

Yes

If ‘yes’, please give details:

Previous Employment 1

Position Held

Job Titles and Duties:

Reason for Leaving:

Previous Employment 2

Position Held

Job Titles and Duties

Reason for Leaving

Previous Employment 3

Position Held

Job Titles and Duties

Reason for Leaving

Current Membership of Professional Bodies: (Please note any professional bodies you are a member of or are registered with.)

Other Employment: (Please note any other employment you would continue with if you were to be successful in obtaining this position.)

Referee 1

Company

Position Held

Address

Contact Number

Relationship

Referee 2

Company

Position Held

Address

Contact Number

Relationship

Leisure: (Please note your leisure interests, sports and hobbies, other pastimes etc.)

Criminal Record: (Please note any criminal convictions. If none, please state. In certain circumstances, employment is dependent upon obtaining a satisfactory National Police Check and / or Working with Children Check.)

Please detail here your reasons for this application, your main achievements to date and strengths you would bring to this role. Specifically, please detail how your knowledge, skills and experiences meet the requirement of this role (as summarised in the position / job advertisement.)

General Comments

DECLARATION (Please read this carefully before agreeing and submitting this application): 1. I confirm that the above information is complete and correct and that any false or misleading information will give my employer the right to terminate any employment without notice. 2. I agree that the employer reserves the right to require me to undergo a medical examination including drug and alcohol testing. I understand that should the employer require further information and wish to contact my doctor with a view to obtaining a medical report, the employer will inform me of their intention and obtain my permission prior to contacting my doctor. In addition, I agree that this information will be retained on my personnel file during employment and for up to six years thereafter. 3. I agree that should I be successful in this application, I will, if required, apply for a National Police Check and / or Working with Children Check. I understand that should I fail to do so, or should the check not be to the satisfaction of my employer, any offer of employment may be withdrawn, or my employment terminated.

I Have Read the Above Declaration

I Agree to ALL Terms in the Above Declaration

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