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Turners Engineering Employment Application Form

TO BE FILLED OUT BY THE APPLICANT:

The information you provide on this form is initially required to determine your suitability for the position that you are applying for. More information may be required at the interview. All information given is strictly confidential. Not completing the sections marked ?optional? will not prejudice your application.

Position Applied for
PERSONAL DETAILS
Last Name
Given Names
Date of Birth (optional)
dd/mm/yyyy
Current Residential Address
Home Telephone Number
Work Telephone Number
Mobile Phone Number
Email Address
Are you currently employed?	YES NO
DRIVERS LICENCE DETAILS
State
Number
Class's
Expiry
Trade Qualification	Diesel Fitter Boilermaker Fitter & Turner Machinist Welder Electrician Operator Other
Education -Highest Level Achieved	SECONDARY TERTIARY
Certificates of Competency attained (e.g. Trade, Machinery Competency, First Aid)
NB: Copies of Certificates must be attached
Certificate/Competency Name (1)
Cert / Comp No (1)
Year Completed (1)
Expiry Date (1)
Certificate / Competency Name (2)
Cert / Comp No (2)
Year Completed (2)
Expiry Date (2)
Employment History - give details of last three jobs or any job held for 3 years or more.
Employer (1)
Supervisor/Manager (1)
Position (1)
Reason for leaving (1)
From date (dd/mm/yyyy) (1)
To date (dd/mm/yyyy) (1)
Employer (2)
Supervisor/Manager (2)
Position (2)
Reason for leaving (2)
From date (dd/mm/yyyy) (2)
To date (dd/mm/yyyy) (2)
Employer (3)
Supervisor/Manager (3)
Position (3)
Reason for leaving (3)
From date (dd/mm/yyyy) (3)
To date (dd/mm/yyyy) (3)
Last salary/wage
References - three people (not relatives) you have worked for.
Name (1)
Phone (1)
Name (2)
Phone (2)
Name (3)
Phone (3)
Have you ever claimed worker’s compensation for injury or disease?	YES NO
If yes, give details:
Do you have any physical disability or medical condition that would affect your ability to do the job?	YES NO
If yes,give details:
Are you prepared to work overtime, shiftwork or be transferred as applicable?	YES NO
When are you able to commence work?
*I accept declaration below & declare the information supplied to be true
Dated and submitted dd/mm/yyyy

please type the letters in the image above

* Denotes a Required Field

DECLARATION Division 8 Section 79

Where it is proved that the worker has, at the time of seeking or entering employment in respect of which he claims compensation for a disability, wilfully and falsely represented himself as not having previously suffered form the disability a dispute resolution body may in its discretion refuse to award compensation which otherwise would be payable.
I declare that the information I have given on this form is complete and correct. I agree that the referees may be contacted and I understand that I will be required to undergo a medical examination and pass the company?s Medical Criteria prior to any job offer being made.

Thank you for your Employment Registration Form submission,we will be in contact soon.