GENERAL SECTION
AREA e.g. Brisbane, Logan, Gold Coast, Tweed Heads-
Brisbane
Logan
Gold Coast
Tweed Heads
FIRST NAME:
SURNAME:
Email address:
ADDRESS DETAILS:
HOUSE NUMBER AND STREET NAME:
Suburb:
State:
Post Code:
Best Contact Phone No:
Mobile:
Date of Birth: (dd / mm / yyyy)
Are you an Australian Citizen?Yes
No
AVAILABILITY
Are you seeking to be employed on a:FULL TIME BASIS
CASUAL OR PART TIME BASIS
Days Available: e.g. mon,tues,wed,thu,fri,sat,sun
When are you able to start:
DRIVING
Do you have a current drivers licence?Yes
No
Class of licence held:
Can you drive a manual car competently?Yes
No
Have you lost your licence in the last 2 years?Yes
No
If yes, give all details:
Have you ever been convicted of a criminal offence?Yes
No
If yes, give all details to criminal offence:
MEDICAL
Do you have any health or physical problems?Yes
No
If yes, to any health or physical problems, give all details:
Do you forsee any problems with heavy physical work / lifting heavy items?Yes
No
Have you ever suffered an injury or illness, which affected your ability to work?Yes
No
If yes, to the above questions give details:
EDUCATION
Last school attended:
Finishing Year Level:
Qualifications or Trade:
Have you previously worked for Shaggi Enterprises?Yes
No
PRESENT / LAST JOB
May we contact your current employer?-
Yes
No
Date employed From: month / year
Date employed To: month / year
Location:
Position held:
Employment type:-
Full Time
Part Time
Casual
Salary
Employers Name:
Reason for leaving:
Reference name:
Reference phone number:
How did you hear about us?-
Google
Super Amart
Furniture N More
Gumtree
Yahoo
Ebay
Friend
Employment agency
Other
AUTHORISATION AND DECLARATION - As a condition of my application, I authorise investigations of all statements contained herein.
Do you consent?-
Yes
No
