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Your Personal Information
Your Name
(Required)
First
Last
Date of Birth
(Required)
DD dash MM dash YYYY
Your Email Address
(Required)
Your Phone
(Required)
Address Line 1
Address Line 2
City
State
QLD
NSW
ACT
VIC
SA
WA
NT
TAS
Post Code
Occupation / Location / Skills / Licences & Training
Referred by
Occupation
(Required)
Please Select
Framer
Sheeter
Setter
Carpenter
Labourer
Apprentice
Other
Preferred Location
(Required)
Please Select
Brisbane
Gold Coast
Sunshine Coast
Skills and Competencies
(Required)
Licences
Drivers Licence
(Required)
Please Select
Car / Bike
Light Rigid
Medium Rigid
Heavy Rigid
None
EWP Operator Licence:
(Required)
Please Select
Below 11m (yellow card)
Above 11m (high risk)
None
Fork Lift Licence Number:
Training Completed
Work Safely at Heights?
(Required)
Yes
No
Asbestos Awareness?
(Required)
Yes
No
Workplace Impairment (WIT)?
(Required)
Yes
No
Have you completed a Fit Test? If so, what was the testing method:
(Required)
Quantitative – uses specialised equipment to measure how much air leaks into the respirator. This type of test can be used on half-face respirators, full-face respirators and PAPR.
Qualitative – a pass/fail test that relies on the wearer’s ability to taste or smell a test agent. This type of test can only be used on half-face respirators.
No - I have not completed a Fit Test
Previous Employment / References
Reference 1
(Required)
Please list your previous employers, the dates you worked and the position you held
Company
Dates
Position / Job
Reference Person
Phone
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Reference 2
(Required)
Please list your previous employers, the dates you worked and the position you held
Company
Dates
Position / Job
Reference Person
Phone
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Remove
Reference 3
Please list your previous employers, the dates you worked and the position you held
Company
Dates
Position / Job
Reference Person
Phone
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Remove
Declaration
Do you have or suffer from any condition (medical or physical or otherwise) that may affect your ability to perform the job or may be affected by the performance of the job. Tasks undertaken in the job my include, but are not limited to – working overhead; walking and standing; lifting and carrying; working at heights; operating powered hand tools; repetitive movement of upper limbs (Please tick below):
(Required)
Yes
No
Are you Covid Vaccinated?
(Required)
Yes - Fully Vacinated
Prefer not to say
No
Have you made a workcover claim in the last 2 years?
(Required)
Yes
No
I hereby declare that all the information provided by me in the application form is true and correct to the best of my knowledge:
(Required)
Please Select
Confirmed
Unable to Confirmed
Date
(Required)
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