APPLICATION FOR EMPLOYMENT

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EMERGENCY CONTACT

INCOME EXPECTATIONS

What are your income expectations?

DETAILS OF EMPLOYMENT

**Please provide details below ( at least the last three positions held )

Position #1

Position #2

Position #3

Position #4

Position #5


REFEREES / REFERENCE NOMINEES

** WORK references ONLY (not family members or friends)

Must supply MINIMUM OF TWO names and companies who could speak on your behalf

Referee #1

Referee #2

Referee #3

Occupational Licences & Certificates

Please indicate your licences/training (please provide copy/s with your application)

First Aid

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Drivers Licence

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Qualifications

** Please advise your qualifications and provide certificates where possible**

Health and Safety / Medical Questionnarie

Please answer the following questions and provide details where applicable.

Injury #1

Injury #2

Injury #3



Do you now or have you ever had any concerns with the following?

Drugs and Alcohol in the Workplace - Zero Tolerance Policy

We have a zero tolerance policy for the consumption and presence of drugs and alcohol whilst at work.

Drug and Alcohol testing will occur and is on a random basis


PRIVACY & PERSONAL INFORMATION CONSENT

Please complete the following consent statement

consent to the collection of necessary personal information, including age, gender, medical history / reports, address details, and the disclosure of information to third parties, medical practitioners and psychological service providers.

I agree to undertake all medical tests and examinations as required to ensure my capability to perform the tasks required of the position for which I have applied. 

I hereby declare that the information I have provided in this form is true and accurate and I authorise the company to verify any information if required. Any false or misleading information may result in the termination of my position / application.

I have read and understood my rights in respect of access to and collection of my personal information.

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