PLEASE ATTACH YOUR RESUME BEFORE COMPLETING THE FORM

Contact Details:
(At least one of these must be completed.)*
What is your first name?*
What is your last name?*
What is the first line of your actual street address*
What is the second line of your actual street address?
What is your actual suburb*
What is your actual State*
What is your actual postcode*
What is your mobile phone number?*
What is your email address?*
What is your home phone number?
Emergency Contact Name and Number

Employment:
(At least one of these must be completed.)*
Are you currently employed?*
If so, what notice period do you need to give?
What is your ideal position?*
What date are you available to start? (Please click the Select Date button to display calendar)
Work Availability - hours/days? Hold Ctrl button to select multiple days
Type of work you are looking for
Desired Work Location
What is your desired annual salary package?
Do you have a driver's licence?
Do you have access to a vehicle?
Are you registered with a job active provider?
If yes please provide name and location

Work Eligibility
(At least one of these must be completed.)*
Are you an Australia resident or permanent citizen?*
If no, do you hold a current work visa for Australia?
If yes, what type of work visa do you hold?
If you are not a citizen or permanent resident of this country please enter your visa expiry date (Please click the Select Date button to display calendar)

Please attach copies of tickets, licenses, visa and passports
Ensure all fields containing an asterix (*) are completed by selecting the edit button

Skills

Skill Skill Group Skill Type

Work History

Start Date End Date Company Position

Employment Policies
(At least one of these must be completed.)*
Consent to Police Check?*
Consent to Medical?*
Consent to Pre-employment and random Drug Test?*
Consent to Working with Children Check?*

Health and Safety
The following questions are asked in compliance with the Accident Compensation Act 1985 Section 82 (7) which requires an applicant to disclose information about pre-existing injury or illness that could affect their ability to perform the tasks of the job
Have you had a previous injury or illness that could affect your health and safety or that of others whilst doing your job?*
Are there restrictions on the tasks of the job for which you have applied that could arise from any previous injury/illness or health conditions*
If you answered Yes to any of the above please provide details of injuries/illnesses/claims
Failure to disclose accurate health and safety information may result in legal action by Conquest Recruitment Group

Declaration
The information provided above is to the best of my knowledge an accurate and true relection of my previous employment and status.
Declaration Acknowledgement*
Acknowledgement Date (Please click the Select Date button to display calendar)*