Your Particulars, all *fields are required
Date of Birth? date/month/year
New Employment Details & Authority to Commence
Position Applied for?
Do you hold an Australian Electrical Licence?
YesNo
If yes please indicate which State?
Australian Capital TerritoryNew South WalesVictoriaQueenslandSouth AustraliaWestern AustraliaTasmaniaNorthern Territory
If no please indicate which Country you attained your trade qualifications?
AfghanistanAlbaniaAlgeriaAndorraAngolaAnguillaAntigua & BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia & HerzegovinaBotswanaBrazilBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChina - Hong Kong / MacauColombiaComorosCongoCongo, Democratic Republic of (DRC)Costa RicaCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFijiFinlandFranceFrench GuianaGabonGambia, Republic of TheGeorgiaGermanyGhanaGreat BritainGreeceGrenadaGuadeloupeGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHungaryIrelandIcelandIndiaIndonesiaIranIraqIsrael and the Occupied TerritoriesItalyIvory Coast (Cote d'Ivoire)JamaicaJapanJordanKazakhstanKenyaKorea, Democratic Republic of (North Korea)Korea, Republic of (South Korea)KosovoKuwaitKyrgyz Republic (Kyrgyzstan)LaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMadagascarMalawiMalaysiaMaldivesMaliMaltaMartiniqueMauritaniaMauritiusMayotteMexicoMoldova, Republic ofMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmar/BurmaNamibiaNepalNew ZealandNicaraguaNigerNigeriaNorth Macedonia, Republic ofNorwayOmanPacific IslandsPakistanPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarReunionRomaniaRussian FederationRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovak Republic (Slovakia)SloveniaSolomon IslandsSomaliaSouth AfricaSouth SudanSpainSri LankaSudanSurinameSwedenSwitzerlandSyriaTajikistanTanzaniaThailandNetherlandsTimor LesteTogoTrinidad & TobagoTunisiaTurkeyTurkmenistanTurks & Caicos IslandsUgandaUkraineUnited Arab EmiratesUnited States of America (USA)UruguayUzbekistanVenezuelaVietnamVirgin Islands (UK)Virgin Islands (US)YemenZambiaZimbabwe
Do they have the following tickets? Use shift key for multiple selections*
White CardEWPOther
If other, please state?
Are you an Australian Resident?
---YesNo
Emergency Contact - Next of Kin
Are there any pre-existing health conditions that may be an impediment to your capacity to perform your duties?
Form to be completed ASAP
BY INSERTING MY NAME BELOW AND SUBMITTING, I HEREBY AGREE AND UNDERSTAND THAT AS AN EMPLOYEE FOR LUHAN GROUP, A LABOUR HIRE COMPANY, I HAVE TO COMPLY WITH ALL CLIENT AND OR SITE SPECIFIC OCCUPATIONAL HEALTH AND SAFETY REQUIREMENTS. I NEED TO NOTIFY MY EMPLOYER IMMEDIATELY SHOULD ANY ACCIDENTS, INCIDENTS OR HAZARDS ARISING IN THE COURSE OF EMPLOYMENT AND I ALSO UNDERSTAND THAT SHOULD I BE ASKED TO PERFORM ANY TASKS I AM NOT QUALIFIED OR COMFORTABLE WITH, THAT I WILL NOTIFY MY EMPLOYER (LUHAN GROUP) AND ALSO MY CURRENT SUPERVISOR.
