Application for Employment.
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Personal Details
Surname
First Name
Street Town/Suburb State Postcode
Phone
Fax
 Mobile  
Email
D.O.B

Sex

 Marital Status
Height (cm) Weight (kg)
Next Of Kin Relationship Contact No
Interests/Hobbies/Sports
Drivers License No State Expiry Classes
Do you have any medical problems/difficulties that may affect your work?   No Yes
  Specify
Do you have a criminal record?   No Yes
  Specify
Education Details
When did you finish high school? (e.g. 2002) Grade Completed
Other Courses Completed
The Available Position
Job Title
Preferred Location
What are your main strengths for this position?
How did you find out about Jumbuck?
Are you interested in a rural traineeship?
Yes No
When are you available to start?
Employment History
Provide previous employment details (start with most recent)
Dates   From To
Position

Employer
Address
Contact Person Phone Position
           
Dates   From To
Position

Employer
Address
Contact Person Phone Position
           
Dates   From To
Position

Employer
Address
Contact Person Phone Position
           
Have you previously made any workers compensation claims? Yes No
Referees
Name Relationship Contact No
Name Relationship Contact No
Name Relationship Contact No
Declaration
I Hereby declare that the information in this application is true and correct
Your Name Date