Application Form
Given Name/s: Preferred Name:
Surname:
Title: Mr Mrs Ms Miss
DATE:
Residential Address: (Not PO Box)
Postal Address (if different from Residential Address):
Suburb State P/Code Suburb State P/Code
Home Phone: Mobile Phone:
Email address for Payslips Where did you hear about NSP?
Do You Have Steel Capped Safety Boots:
WorkPro CIN # WorkPro PIN #
Emergency Contact Name: Number:
Do you have a pre-existing injury, condition or disease that could be affected by your employment with NSP Personnel? (Refer Injury Disclosure) Details:
Date of Birth:
Country Of Birth: Nationality:
Own Transport Yes No
Do You Have the Right To Work in Australia? YES NO
Job Seeker or Job Network ID
Type of work you ARE willing to accept Day Shift Afternoon Shift Night Shift Rotating Shifts Other______________________
Preferred Position/s Sought
1.
2.
Preferred Work Locations
1.
2.
Employment History 1 Position ______________________________ Salary _____________
Company Name ____________________________________________
Ph: __________________ Dates Employed _______________________
Contact ___________________________________________________
Reason for Leaving __________________________________________
Duties _____________________________________________________
___________________________________________________________
Employment History 2 Position ______________________________ Salary _____________
Company Name ____________________________________________
Ph: __________________ Dates Employed _______________________
Contact ___________________________________________________
Reason for Leaving __________________________________________
Duties _____________________________________________________
___________________________________________________________
Bank Details Bank Name: ____________________________________ Branch: ________________________ (e.g., Commonwealth, ANZ etc) (ie. Knox, Dandenong Plaza etc) Bank BSB: (6 Digits)_______________ Account Number:(Up to 9 Digits)_____________________________ (Bank State Branch) Name Account held in: __________________________________________________________ (e.g., John Citizen) Due to privacy legislation passed in December 2001, NSP Personnel is no longer able to confirm banking details with your financial institution. As such you must approve the account details. NSP Personnel cannot be held responsible for incorrect information
NA
ME: ___________________________________ D
ate Registered: _________
initiator:[email protected];wfState:distributed;wfType:email;workflowId:abbb3887e3896a4b8f4f59bc9ea135cb
Application Form
Referee 1 Name of Supervisor / Manager: ________________________________
Company Name ____________________________________________
Ph: _____________________ Mobile: __________________________
Referee 2 Name of Supervisor / Manager: ________________________________
Company Name ____________________________________________
Ph: _____________________ Mobile: __________________________
Referee 3 Name of Supervisor / Manager: ________________________________
Company Name ____________________________________________
Ph: _____________________ Mobile: __________________________
Referee 4 Name of Supervisor / Manager: ________________________________
Company Name ____________________________________________
Ph: _____________________ Mobile: __________________________
Trade Qualifications / Certificates: School/Institute
Type of Qualification
Year Obtained
Details
Licenses: Type of License
Year Obtained
Details
Candidates Authorisation And Declaration
I certify that all statements provided in this Application Form are, to the best of my knowledge, true and correct. I authorise NSP to make any reasonable inquiry of former employers, associations and referees to obtain information to enable occupational potential to be accurately assessed. I authorise NSP to release this information to employers for the sole purpose of assisting me in obtaining employment. I acknowledge that I have read and understood the matters set out above and that an NSP Representative has provided me with an opportunity to discuss any questions or concerns that I may have in relation to the above matters. I consent to NSP copying and printing my curriculum vitae / resume for NSPs own records and for forwarding on to prospective employers. I understand that whilst working for NSP Personnel some sites may require union dues or subscriptions to be de-ducted pro rata amount from my weekly pay. I further understand that if my assignments ends and I no longer wish to be a member of these unions I am responsible for cancelling my memberships. I also acknowledge that I have been provided with NSPs OH&S and Drug and Alcohol Policy and understand and agree to abide by these policies.
If filling out this form online, please type your name as your signature.
Candidates Name: Candidates Signature:
Date:
* I fully understand and agree with the above conditions and confirm all application details as correct.
Application Form
Job Description General /Injury Disclosure
Injury Disclosure NSP Personnel P/L is committed to providing a safe working environment for all employees. As part of this it is our objective to ensure that employees are not required to work in duties that they are not able to perform safely. With that in mind, you will find below a General Job Description and nature of the work for which you are applying. Please read this document carefully and discuss any queries you may have prior to formally applying for employment with NSP Personnel P/L. Pursuant to section 82(7) and (8) of the Accident Compensation Act 1985, which came into effect on 29 June 1998, you are required to disclose to your employer any pre-existing injury or disease that you have suffered of which you are aware and could reasonably be expected to foresee could be affected by the nature of the proposed employment. We advise that a failure to make a disclosure, or making a false or misleading disclosure, would disentitle you to compensation, pursuant to the Accident Compensation Act should you suffer any recurrence, aggravation, acceleration, exacerbation or deterioration to your pre-existing injury or disease arising out of or in the course of or due to the nature of employment with NSP Personnel P/L. NSP Personnel P/L will rely upon any failure to disclose in accordance with the provisions of the Accident Compensation Act as the grounds for denying compensation in accordance with Section 82 (7) and (8). Please disclose in the space below any pre-existing injury or disease that you have suffered, which could be affected by the nature of your proposed employment with NSP Personnel P/L.
Job Description General I understand whilst employed by NSP Personnel P/L I am covered by the statutory Work Cover legislation. Whilst working I will be under the direction and supervision of the client. I must NOT engage in any work that is unsafe or that I am not appropriately trained or licensed to perform. I understand that if during an assignment I sustain an injury, illness or serious near miss, I must notify NSP Personnel as soon as possible and no later than 24 hours after receiving the appropriate medical treatment to report the injury. As a casual employee of NSP Personnel P/L, you may be offered a job in the areas of Construction, Maintenance, Production, Warehousing, Transport or the Distribution Industries. These positions will include some or all of the following requirements so should any of these requirements pose a problem, Please identify the position by circling it. 1 Inspecting 2 Heavy lifting 3 Reading 4 Constant bending 5 Writing 6 Constant standing 7 Heights 8 Repetitive work 9 Chemicals 10 Dusty work 11 Fumes 12 Hot conditions 13 Noise 14 Cold conditions 15 Hearing If filling out this form online, please type your name as your signature.
Candidates Name:
Candidates Signature:
DATE:
* I fully understand and agree with the above conditions and confirm all application details as correct.
Application Form
OFFICE USE ONLY
CHECKLIST
1 Licences Sighted and Copied. i.e. Drivers licence and Forklift licence
2 Reference Checks completed, or signed off by Management?
3 Candidate has Steel Capped Safety Boots
4 Bank, Tax & Super forms completed in full?
5 Terms and Conditions of Engagement explained and signed by candidate?
6 Job Description General / Injury Disclosure Form signed?
7 Superannuation Choice Form completed?
8 Privacy & Confidentiality Agreement viewed by candidate
9 Skills Library completed?
10 Work Safety Essentials Induction completed, signed & video watched?
11 WorkPro Online Induction completed and CIN & PIN Numbers recorded?
12 Visa and Right to Work in Australia checked if Applicable? INTERVIEW NOTES
Recruitment Consultants Initials: _________ Date of Interview: _______________
Application Form
Terms
