Moort Scaffolding Company Induction
Moort Scaffolding
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Emergency Contact Name
*
First Name
Last Name
Relationship
Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Emergency Contact Email
*
example@example.com
Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Do you have any medical condition, injury, physical limitation, or prescribed medication that may affect your ability to safely perform the duties required in this role?
*
Please Select
Yes
No
If yes, you will be required to complete a Medical Declaration form before commencing work. This information will be treated confidentially and used to ensure your health and safety while performing your role
White Card
*
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HRWL
*
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Driver Licence
*
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Driver Licence - back
*
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Working at Heights and Confined Spaces if Applicable
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Scaffold Certificate if Applicable
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Other (asbestos, sun overhead awareness, etc)
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