Employee Details & Emergency Contact
Today's Date
-
Day
-
Month
Year
2 digit day, 2 digit month, 4 digit year
Date
Name
*
First Name
Last Name
Preferred name
Residential address
*
Street Address
Unit / apartment (optional)
Suburb / city
State / region
Postal / ZIP code
Email
*
example@example.com
Mobile phone number
-
Area Code
Phone Number
Mobile number
*
Australian mobile number only
DOB
*
-
Day
-
Month
Year
2 digit day, 2 digit month, 4 digit year
Date
Do you have a current Driver's License?
Yes
No
Type of License?
Manual
Auto
Drivers License Number
Driver licence number
*
Country that issued your licence
Emergency Contact
Emergency contact full name
*
First Name
Last Name
Relationship to employee
*
Emergency contact phone
*
Australian mobile or landline
Emergency contact phone number
-
Area Code
Phone Number
Licence expiry date
*
-
Day
-
Month
Year
2 digit day, 2 digit month, 4 digit year
Date
Any driving restrictions or licence conditions?
Take Photo of Front of License
*
Take Photo of back of License
*
Do you have any previous experience?
*
Lawn mowing
Hedging
Gardening
Hand Weeding
Palm Cleaning
Fertilizing
Whipper Snippering
Installing Mulch
Treating Weeds
Gutter Cleaning
Medical Information
Do you have any medical conditions that will affect your ability to carry out heavy labour intensive work?
*
Yes
No
Please provide all relevant information regarding your injuries
Previous Employment Details
Name of previous employer?
Reason for not working there anymore?
When did you stop working there?
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Time worked there?
What hourly rate were you earning in your last job?
Have you ever made a workers compensation claim?
*
Yes
No
Provide details of claim
*
Have you ever been convicted of a crime in Australia?
*
Yes
No
Please provide details and dates of crime
Licences and Certificates
Do you have a current National Police Certificate
Yes
No
Please upload current National Police Certificate
Browse Files
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