Position Applied for:
| MON | TUE | WED | THU | FRI | SAT | SUN |
|---|---|---|---|---|---|---|
| AM | AM | AM | AM | AM | AM | AM |
| PM | PM | PM | PM | PM | PM | PM |
| Full Time |
| Part Time |
| Casual |
| Available Start Date | |
| Any Other Comments |
| First Name | Middle Name | Surname | |||
| Street Address | Suburb | ||||
| State | Post Code | ||||
| Postal Address | Suburb | ||||
| State | Post Code | ||||
| Home Phone Number | Mobile Phone Number | ||||
| Email Address | Date of Birth |
| Contact Name | Relationship | ||
| Address | Suburb | ||
| State | Postcode | ||
| Home Phone Number | Work Phone Number | ||
| Mobile Phone Number | Email Address |
| Most Recent Company Name | |||||
| Poistion | |||||
| Employment Type | Full Time Part Time Casual | Start Date | Termination Date | ||
| Reason for leaving | |||||
| Prior Company Name | |||||
| Poistion | |||||
| Employment Type | Full Time Part Time Casual | Start Date | Termination Date | ||
| Reason for leaving | |||||
| Prior Company Name | |||||
| Poistion | |||||
| Employment Type | Full Time Part Time Casual | Start Date | Termination Date | ||
| Reason for leaving | |||||
| Prior Company Name | |||||
| Poistion | |||||
| Employment Type | Full Time Part Time Casual | Start Date | Termination Date | ||
| Reason for leaving | |||||
Right to Work
I have the legal right to work in Australia because:
I am an Australian Citizen or
I am a Permanent Resident of Australia or
I am hold a Working Visa
Criminal Offences
I have not been convicted of or have any criminal charges pending
I have been convicted of or have criminal charges pending
Please provide details:
Previous association with the Club
I have never worked for Diggers at the entrance
I have previously applied for a poistion at Diggers at the entrance but was unsucessfull with my application
Position Applied for : Date :
I have previously been employed by Diggers at the entrance
Position Held : Termination Date :
| Back | Head | Wrist/s | Ankle/s |
| Neck | Shoulder/s | Hand/s | Hip/s |
| Knee/s | Elbow/s | Finger/s | Other |
What is the current status of the Injury :-
ILLNESS - I have suffered from or am currently suffering from the following :-
| Blackouts | Heart Disorders | Arthritis/s | Skin Disorders |
| Epilepsy | Breathing Disorders | Hernia | Varicose Veins |
| Migranes | Asthma | Allergies | Other |
What is the current status of the Illness:-
HEARING - What is the status of your hearing ?
Normal
Not Normal
Please provide details as to the current state of your hearing :-
SMOKING
I have never smoked.
I have smoked in the past, but have since given up the habit.
I am a smoker.
| First Reference: | Second Reference: | |||
| Name | Name | |||
| Company | Company | |||
| Position | Position | |||
| Phone Number | Phone Number |
| Institution | Start Date | |||
| Qualification | Completion Date | |||
| Institution | Start Date | |||
| Qualification | Completion Date | |||
| Institution | Start Date | |||
| Qualification | Completion Date | |||
| Institution | Start Date | |||
| Qualification | Completion Date | |||
I hereby authorise Diggers at the Entrance (the Club) to obtain, from any person, information in relation to my suitability for employment at the Club. I release any such person, firm or institution from liability for any damage, claims, costs, or expences which may arise from the provision of such information. I expressly authorise the Club to use any information provided by me in relation to my application for employment with the company to assess my suitability for employment. This includes, but is not limited to the information provided on this application form and the attached resume, as well as information obtained from a reference check. I consent to undertaking any numerical or verbal testing as may be required by the Club. I also consent to undertaking a pre-employment medical, which may include a urinary drug screen, if requested and consent to the release of medical information to the Club. In addition, I authorise the Club to use the same information for any purpose related to my future employment prospects with the Club. I authorise the Club to give part or all of the information I have supplied to the Club to an external recruitment agency of the Club's choice if they choose to do so.I confirm that the information provided is accurate in every material respect. I acknowledge I have a right to access and respond to any information which I consider inaccurate. I also acknowledge that my application may be rejected or I may be summarily dismissed if any of the information provided by me is in any way inaccurate or misleading in any respect material to my employment with the Club.
| Name (required) | |
| Date: |
Yes, I agree to the Above terms and conditions, or No, I DO NOT agree to the above terms and conditions