Careers EMPLOYMENT APPLICATION & REGISTRATION Employment Application / Registration Form Please complete the form below to register your interest for a career with GVMI. Fields marked with an asterisk * are mandatory. Personal InformationFirst Name*Last Name*Preferred NameAddressSuburbPostcodeTel No. : – Home:MobileWorkEmail Address* Date of Birth (not mandatory) Shirt Size Job InformationHow were you referred to GVMI?This field is hidden when viewing the formService TypeServiceAre you applying for Casual work? Yes No Are you applying for Regular P/T Work Yes No Are you applying for Regular F/T Work Yes No Can you work Weekends? Yes No Can you work Evenings? Yes No Are you available to work On-Call? Yes No What days and hours are you available to work? Monday (day) Monday (night) Tuesday (day) Tuesday (night) Wednesday (day) Wednesday (night) Thursday (day) Thursday (night) Friday (day) Friday (night) Saturday (day) Saturday (night) Sunday (day) Sunday (night) If hired, when are you available to work? ASAP Specific Date Starting Date Do you speak or understand any foreign languages? Yes No If yes, which language:Desired Hourly Rate(AUD) Certificate/LicenseSecurity Licence NumberSecurity Licence Expiry Date Where was the course completed?First Aid Certificate NumberFirst Aid Certificate Expiry Date Where was the course completed?RSA Certificate Number:RSA Certificate Expiry Date Where was the course completed?Drivers License NumberExpiry Date Issuing StateTraffic ControlExpiry Date Issuing StateWhite CardExpiry Date Issuing StateWorking with Children CheckExpiry Date Issuing StateAny other National LicensesExpiry Date Issuing State Employment HistoryAre you currently employed? Yes No If yes, what is the Company Name?How often do you work for them?Position Education Training and ExperienceAre you currently studying? Yes No if Yes, is it Part-Time Full-Time is it TAFE University What are you studying?What High School did you attend?Grade Completed?Do you have any other Experience, Education, Training, Qualifications or Skills that should be brought to our attention? Occupation Health and SafetyDo you suffer from any of the following: Asthma Heart Disease / Disorder Epilepsy Any Mental Conditions HIV Related Illnesses Hearing Loss Colour Blind Have you ever been subject to a Workers Compensation Claim? Yes No If Yes, please give detailsEmergency ContactContact NameContact NumberRelationship Legal MattersAre you an Australian Citizen? Yes No If No, give details:Have you ever had an AVO taken out against you? Yes No If Yes, give details:Have you ever been charged with criminal offence? Yes No If Yes, give details:Are you, to your knowledge, under investigation, charged, or awaiting a hearing? Yes No If Yes, give details: Administration DetailsTax File NumberSuperannuation FundMember NumberAustralian Business NumberUnique Superannuation Fund IdentifierPlease note: if you do not nominate a preferred superannuation fund within 30 days of start of employment then you will automatically be set up with our default fund, Host Plus. Bank DetailsBank Account NameBSBBankAccount Number Δ
