Confidential Employment Application

“Honesty, Integrity, Security.”

Personal Particulars - Step 1 of 5

Surname *

First Name(s) *

Have you ever been known by another name?

Address *

Address Line 1

City

State / Province / Region

Postal Code

Phone Number(Home)

(Work)

(Mobile) *

Fax Number

Email *

Declaration

Drivers License No. *

Expiry Date *

Classification *

How long held? *

Security License No. *

Expiry Date/ Issued (State) *

How long held? *

Endorsements

Endorsements 2

Firearms License No.

Expiry Date

Classification

How long held?

Other Licenses

Other Licenses 2

Have you ever been refused motor vehicle insurance? *

If Employed, how soon are you able to start? *

If required can you work in remote locations for up to two weeks at a time?

Employment History

Security Experience

Other Relevant Experience

Have you been vaccinated for COVID-19? *

Is there any medical condition that could limit your performance in the nature of the work you are applying for? *

If Yes, please give details

Do you suffer from any ailment or disability or are you required to take any medication which may:

• Affect your work performance? *

• Affect your attendance at work? *

Have you ever made a workers compensation claim *

If Yes, please give details

Do you suffer from any physical disability or injury? *

Do you suffer from any condition that requires the use of Prescribed Medications? *

Do you suffer from Fits of any kind? Eg. Epilepsy *

Are you Diabetic *

Are you Colour Blind? *

Do you drink Alcohol? *

Do you Smoke? *

Do you use any Unauthorised Drugs? *

Do you use Corrective Lenses? *

If employed, do you agree to undergo Medical or Drug Testing if requested? *

Do you have any Civil or Criminal convictions? (Including traffic offences) *

Do you have a current Police Clearance Certificate? *

If not, are you willing to get one? *

Explanation for any of the above

Do you have a WWC Working with Children Certificate? *

If not, are you willing to get one?

Have you ever been convicted of a criminal offence in Australia or Overseas *

If yes please give details

Have you ever declared or been forced into bankruptcy *

If yes please give details

Reference

Recruitment Policy

Recruitment Policy: The company’s policy is to employ the best qualified personnel and provide equal opportunity for the advancement of employees including promotion and training and not to discriminate against any person in accordance with the relevant legislation.

Statement

I understand that:
1. This application does not constitute a contract of employment.
2. Any offer of employment will be based on the information recorded on these forms and given during the interview. If information supplied by me is false, this application will not be considered, and or any subsequent employment may be subject to termination as a consequence.
3. Appointment to any position will require compliance with the company conditions of employment.
4. I am prepared to comply with the requirements for the company to undertake security clearance checks.
5. I shall present myself for a medical examination if so requested by the company and any offer of employment will be conditional upon my being certified as medically fit for the job.
6. If so requested by the company I will undertake to complete a confidentiality agreement in the form presented by the company.
7. I authorize the company to obtain references to support my application and release the company and referees from any liability caused by giving such information.
8. Where it is required under Government Legislation, any offer of employment is conditional upon my being granted the appropriate licence/s for the work to be undertaken.
9. I understand that completion of this application does no guarantee employment.

Applicant Signature (Print full name) *

Date *

Witnessed Signature

Date

Upload Files

Previous Employment Declaration

Remote/Mining

Have you ever previously worked in the Security or Mining Industry?

If yes please give details:

Company's Name

Date From:

Date To:

Reason for leaving

Have you ever previously worked in remote locations?

If yes please give details:

Company's name / location

Date From:

Date To:

Reason for leaving

I declare that the information I have given on this form is correct. I understand that it is an offence to give false or misleading information and that it may result in the immediate termination of my employment.

Signature (Print full name)

Date

Name