Affective.com.au

Section-I

POSITION APPLIED FOR

TODAY'S DATE

MINIMUM REQUIREMENTS

UPLOAD DOCUMENT

FAMILY NAME

FIRST NAME

ADDRESS (No & Street)

TOWN/SUBURB

POSTCODE

DATE OF BIRTH

TELEPHONE (Home)

MOBILE

EMAIL ADDRESS

DRIVERS LICENCE NO

CLASS

EXPIRY DATE

YOU MUST SUPPLY A CURRENT ROADS & MARITIME SERVICES DRIVING RECORD IF APPLYING FOR A DRIVING POSITION. UNTIL THIS IS RECEIVED YOUR APPLICATION WILL NOT PROGRESS.

IN CASE OF EMERGENCY PLEASE NOTIFY (name, address, phone & relationship)

Section-II

EDUCATION AND TRAINING (Including Secondary School, Trade and Post Trade Certificates, Technical College etc.)

FROM

TO

FULL/PART TIME

INSTITUTIONS

STANDARD QUALIFICATIONS ACHIEVED

COMMENTS

DATE

Section-III

DO YOU HOLD ANY CERTIFICATES OF COMPETENCY?
PLEASE SUPPLY A COPY OF ALL TICKETS AND DRIVERS LICENCE WITH YOUR APPLICATION

	CERTIFICATE No.	DATE ISSUED	EXPIRY DATE
ASBESTOS REMOVAL - BONDED
ASBESTOS REMOVAL - FRIABLE
BHP INDUCTIONS
BOILERMAKING / WELDING
BLUESCOPE PASSPORT
CONFINED SPACE/LEAD PAINT TICKET
CRANE & HOIST OPERATION
DEMOLITION - EXPERIENCE ( YEARS)
CRANE - DOGGING
FIRST AID
OHS INDUCTION (WHITECARD)
OXY CUTTER - DEMOLITION
PLANT OPERATOR TICKETS
RISI – (Railcorp)
SCAFFOLDING or RIGGING
TOOLS (POWER/EXPLOSIVE)
TRACK AWARENESS
TRAFFIC CONTROL (please circle) (blue) (yellow) (red) (orange)
OTHER - SPECIFY

SUPPLY AT LEAST 5 YRS EMPLOYMENT DETAILS (These details are in confidence)

* MUST BE ANSWERED

CURRENT OR MOST RECENT EMPLOYER

*Company Name

Address

Office Phone No

Contact Name

Contact’s Ph/Mob

Nature of Employer’s business / industry

Position held and details of duties

Date employed from

to

Reason for desiring to leave (or have left)

PREVIOUS EMPLOYER 2

*Company Name

Address

Office Phone No

Contact Name

Contact's Ph/Mob

Nature of Employer's business / industry

Position held and details of duties

Date employed from

to

Reason for desiring to leave (or have left)

Comments and queries

If you are selected, you will be required to fill out a supplementary questionnaire before being eligible to attend an interview. If you do not upload your qualifications or RMS driving record (if applicable) via this form, you will need to attach them to your completed questionnaire.

I hereby declare that the information provided by me in this Application for Employment is a true and accurate statement and I acknowledge and understand that falsification of any information provided by me herein will invalidate this application and may result in the termination of any contract of employment with Affective Services (Aust) Pty Ltd arising from this Application for Employment.

Sign	Print Name	Date
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