Employment Application
Please ensure that you attach or send in your resume with this application form.
Position
Position applying for:
*
Have you received a position description and or the position been described to you?
*
Yes
No
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone No.
*
Email
example@example.com
Next of Kin Details
Name
*
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Email
example@example.com
Bank Account & Superannuation Details
Bank Account Details
Superannuation
Please complete the attached Superannuation standard choice form
Upload Superannuation standard choice form
Browse Files
Cancel
of
Coal Long Service Leave Member Number
Tax Declaration
Please click the link below to complete tax declaration
Upload Tax Declaration Form
Browse Files
Cancel
of
Licences & Qualifications
Upload copies of Resume/Drivers Licence/High Risk Licences/Tickets/Qualifications/Inductions
*
Browse Files
Cancel
of
Employment History
Last 2 Employers
Name of previous employer
Date Started
-
Day
-
Month
Year
2 digit day, 2 digit month, 4 digit year
Date
Date Finished
-
Day
-
Month
Year
2 digit day, 2 digit month, 4 digit year
Date
Reason for leaving
Name of previous employer
Date Started
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Date Finished
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Reason for leaving
Reference 1
*
Reference 2
*
Click
HERE
to download the Fairwork Information Sheet regarding minimum workplace entitlements.
Health
Applicants will need to be able to pass a medical including drug & alcohol test.
Have you or are you suffering from any medical including mental illness or other condition which may impede you from the inherent requirements to perform the role?
*
Yes
No
Details
Are you taking any medication that might affect your ability to safely operate any plant, machinery, tools, equipment or a vehicle?
*
Yes
No
Details
Declaration of Applicant
I declare that all the above information is true & correct and I have downloaded a copy of the Fairwork Information Sheet.
Signature
Date
-
Day
-
Month
Year
2 digit day, 2 digit month, 4 digit year
Date
Submit
Should be Empty: