1800 657 765
NW F01 122 Studio Lane Docklands VIC 3008
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Employment Application
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Employment Application
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PERSONAL DETAILS
SURNAME:
*
FIRST NAME:
*
MIDDLE/OTHER:
DATE OF BIRTH:
*
CONTACT INFORMATION
HOME PHONE:
MOBILE PHONE:
*
BUSINESS:
EMAIL ADDRESS:
*
HOME ADDRESS
UNIT/HOUSE NUMBER:
ADDRESS NAME:
SUBURB:
CITY:
*
STATE
*
POST CODE:
*
EMERGENCY CONTACT
CONTACT 1:
FULL NAME:
*
RELATIONSHIP:
*
PHONE:
*
EMAIL ADDRESS:
*
CONTACT 2:
FULL NAME:
RELATIONSHIP:
PHONE:
EMAIL ADDRESS:
APPLICATION QUESTIONS
Outline your experience in the Cleaning Industry?
*
Describe your character?
*
Any other comments you wish to tell us about?
*
LICENCE DETAILS
1. DRIVING LICENCE - STATE:
LICENCE NUMBER:
*
EXPIRY DATE:
*
Attachment
*
Click or drag a file to this area to upload.
2. PASSPORT COUNTRY:
PASSPORT NUMBER:
*
EXPIRY DATE:
*
Attachment
*
Click or drag a file to this area to upload.
OTHER:
LICENCE NUMBER:
*
EXPIRY DATE:
*
Attachment
*
Click or drag a file to this area to upload.
Police Check
*
Click or drag a file to this area to upload.
WORK PERFORMANCE AND CHARACTER REFERENCES
1. Reference Name:
Relationship:
Phone:
Email:
How long Known?
2. Reference Name:
Relationship:
Phone:
Email:
How long Known?
3. Reference Name:
Relationship:
Phone:
Email:
How long Known?
APPLICATION QUESTIONS
Have you been known by any other name? "YES" or "NO" if Yes (Give Details)
*
Have you ever made a claim for a workplace injury or accident? "YES" or "NO" if Yes (Give Details)
*
AVAILABILITY
MONDAY
From
To
Comments/other
TUESDAY
From
To
Comments/other
WEDNESDAY
From
To
Comments/other
THURSDAY
From
To
Comments/other
FRIDAY
From
To
Comments/other
SATURDAY
From
To
Comments/other
SUNDAY
From
To
Comments/other
DECLARATION
I,
*
Signature
Clear Signature
Date:
*
Submit