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- EMPLOYMENT REGISTRATION FORM -TITLE Mr Mrs Ms Miss [please tick]SURNAME FIRST NAME _ MIDDLE NAME

PREFERRED JOB/WORK DOB / /

RESIDENTIAL ADDRESSSUBURB POST CODE

HOME PHONE NO. ( ) MOBILE NO.

POSTAL ADDRESS POST CODE

EMERGENCY CONTACT RELATIONSHIP _ PHONE NO ( ) _

JOB SEEKER ID JOB NETWORK AGENCY _

CURRENT DRIVERS

LICENCEYes No[pleasetick] LICENCE NO

CLASS

ANY OTHER LICENCES

OR TRADE TICKETS?[Specify i.eTraffic Control Ticket, Forklift, Front end loader etc.] Proof required

DO YOU HOLD A

CURRENT SAFETY

INDUCTION CARD?

DO YOU OWN THE

Yes No [please tick] DO YOU HAVE A RELIABLE VEHICLE?(Proof required) Yes No [please tick]

Tools of trade

Hardhat

Steel Cap Boots

Safety Glasses

Safety VestFOLLOWING EQUIP?

HandTools [please specify]DO YOU HAVE ANY PRE-EXISTING INJURIES THAT MAY RESTRICT YOU FROM DOING ANY WORK RELATED ACTIVITY?

If yes, please give only brief details.

No Yes

ARE YOU TAKING ANY MEDICATION THAT MAY AFFECT YOUR ABILITY TO OPERATE MACHINERY OR IMPAIR YOUR JUDGEMENT ?

If yes, please give only brief details.

No Yes

WORK HISTORY [last 3 employers]

COMPANY NAME JOB TITLE & TIME THERE CONTACT NAME & PHONE NO.

1.

2.

3.

NAME DATE

O'Reilly James Nicholas

Boilermaking/Maintenance Fitting 15 11

59 Amarina Ave

1983

Mooloolaba 4557

0422500461

Jessica Wife 04 22500481

103409478

C

Sockets, spanners, clamps, drills, hammer, squares, punches etc.

Peter Gray +6478738788Site foreman 3years 9 monthsGray Construction

N/AArmy Officer 1 year 8 MonthsNZ Army

UnknownCasual forklift operator 2 yearsPeter Baker Transport

James O'Reilly 3/22

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BUILDING CONSTRUCTION CIVIL CONSTRUCTION LABOURING

Blockwork - laying Asphalt overlay Builders Labourer

Brickwork - laying Asphalting Carpet Laying Experience

Cable Laying Chainman Civil Labourer

Carpentry Crane Operator Fencing Experience

Commercial Foreman Formwork Labourer

Concrete - Exposed Agg Grade Checker Furniture Removals Experience

Concrete - Finishing Leading Hand General LabourerConcrete - Pumping Patching Heavy Lifting

Concrete - Screeding Pipe Layer Landscape Labourer

Concrete - Boxing/laying Spray Sealer Maintenance Experience

Concretor Supervisor Party Hire Experience

Crane Chaser Surveyor Electric Power Tool Use

Demolition PLANT OPERATORS Shop Fitting Experience

Dogman Must show proof of licence Stocktake Control

Draftsmen - Building Backhoe Store Person Experience

Drainage Work Bobcat/Skidsteer Turf Laying

Drilling Dingo Wacka Packa

Electrical Work Dozer TRAFFIC CONTROL

Estimating Dredge Traffic Control ExperienceFibre Glassing Excavator SECURITY

Floor Sanding Forklift Crowd Control Experience

Foreman Grader Guard Experience

Formwork Labourer Loader TRANSPORT

Formwork Carpenter Manitou Agitator Experience

Glazier Roller Articulated Bus

Gyprocker Scraper B-Double Experience

Handyman HORTICULTURE Bus

Insulation Installer Arborist Coach Driver

Jack Hammer Gardening Courier Driver

Joiner Green Keeper Crane Truck Experience

Leading Hand Grounds Keeper Delivery DriverPainting - Brush Hand Hydroponics Dump Truck/Articulated

Painting - Commercial Irrigation Flat/Table Top

Painting - Exterior Structural Landscaping Float Experience

Painting - Interior Lawn Mowing Fuel Tanker Experience

Painting - Residential Nursery Experience Furniture Removal

Paving Planting Garbage Truck

Plastering - Solid Propagation Hiab Experience

Plumbing Pruning Low Loader Experience

Reading Plans Rock Wall building Pneumatic Tanker

Rendering Tree Climber Road Ranger Experience

Residential Tree Doctor Road Train

Rigger MISCELLANEOUS Semi ExperienceRoof Sheet Metal Boat Builder Side Lift Operator

Roofer Tiler Deckhand Table Top/Flat Bed

Scaffolder Fisherman Tilt Tray

Shop Fitter Geologist Tipper Truck

Site Preparation Pest Control Tow Truck

Steel Fixer Aircraft Pilot Truck & Dog Experience

Steel Tyer Pool Maintenance Water Truck Experience

Surveyors Assistant Sawyer LICENCE CLASS

Tiling - Floor and Wall Sewerage Treatment Plant Must show proof of licence

Trades Assistant Shipwright LR (Light rigid)

Trowelling Stonemason MR (Medium rigid)

Waterproofing Swimming Pool Installations HR (Heavy rigid)Yardsman Upholsterer HC (Heavy combination)

MC (Multi combination)

~ SKILLS LIST ~Only tick areas of experience. Minimum of 6 months hands on experience.

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AGRICULTURE AUTOMOTIVE QUALIFIED TRADESMAN

Auger Operator Air Conditioning Must show a Trade Cert or Licence

Bailing Auto Dismantler Trade Qualified Baker

Chaffcutter Operator Auto Electrician Motorcycle Mechanic

Cultivator Automotive Transmission Blocklayer

Farm Labourer Brake & Clutch Experience Boilermaker

Fertilising Experience Car Repairs Bricklayer

Fruit Picking Experience Car Services BuilderHammermill Operator Motor/Coach body builder Cabinet Maker

Harvest Operator Car Detailing Carpenter

Irrigation Experience Diesel Fitter Coach Building

Pineapple Picker Diesel Mechanic Electrician

Seeding Experience Differentials Fibreglasser

Silo Experience Electronic Fuel Injection Glazier

Slashing Experience Exhaust Fitting Gyprock Fixer

Spraying Experience Engine Reconditioning Marine Mechanic

Tractor Experience Gas Conversion Car Mechanic

Vineyard Experience Gearbox Experience Maintenance Fitter

METAL TRADES/ENGINEERING Hydraulics Experience Mechanical Fitter

Aluminium Welding LPG Fitter PainterCNC Operator Motorcycle Repairs Plasterer

Computer - CAD Motor Mechanic Plumber

Bridge/Gantry Crane Operator Panel Beater Printer

Draftsman Steel Radiator Repairs Refrigeration Technician

Dye Setting Experience Car Servicing Sheetmetal Worker

Electroplating Experience Small Engine Mechanic Solid Plasterer

Civil Spare Parts Interpreter Tiler

Mechanical Spray Painting CERTIFICATES

Fabricator Truck Servicing Certified Termite Barrier Installer

Fitter & Turner Tyre Fitter/Car B Class Asbestos

Logistics Tyre Fitter/Truck BSA

Maintenance Fitter Wheel Alignment Chemical ACDCMechanical Fitter Window Tinting Chainsaw

Mig Welding Windscreen Repairs Cherry Picker

Oxy Welding FACTORY Confined Space

Pipe Fitter Woodwork Industry CPR

Plastic Welding Abattoir Experience Crane - Non Slew

Powder Coating Assembly Line Crane - Slewing

Sandblasting Block Manufacturing Demolition Ticket

Stainless Steel Welding Despatcher Dogman

Tig Welding Factory Worker Elevated Work Platform

TRAVEL TO Food Processing Energex Ticket

Brisbane North Glass Industry Cert III Engineering

Brisbane South Meat Processing First AidBrisbane West Packing Hoist

Bundaberg Plastics Experience Horticulture Certificate I

Caboolture Press Operating Horticulture Certificate II

Caloundra Seafood Processing Horticulture Certificate III

Gold Coast Sheet Metal Industry Horticulture Certificate IV

Gympie Timber Industry Cert II Qualified Pest Controller

Hervey Bay MINING Rigger

Ipswich Coal Safe Working At Heights

Maroochydore Dragline Scaffolding Basic

Maryborough Drill Rig Operator Scaffolding Intermediate

Noosa Drillers Offsider Scaffolding Advanced

Redcliffe Gatehouse Senior First Aid CertificateSunshine Coast Gold Trade Contractor Licence

Strathpine Haul Truck Trainer/Assessor

Toowoomba Pipeline 1st Class Welding

Shut Down 2nd Class Welding

Workplace Health & Safety Officer

Only tick areas of experience. Minimum of 6 months hands on experience.

~ SKILLS LIST ~

SUBMIT