EMPLOYMENT APPLICATION

MR./MRS./MISS./_______________________________________DATE OF BIRTH________/_______/_____

FULL NAME: _____________________________________________________________________________

ADDRESS:   ______________________________________________________________________________

TOWN/ SUBURB: ______________________________________POSTCODE:_________________________

PHONE: (    )___________________________________________MOBILE:____________________________

DRIVERS LICENCE No; __________________________________Email Address;_______________________

(In order of preference)

POSITION (S) APPLIED FOR__________________________________________________________________

__________________________________________________________________________________________

Times you are AVAILABLE TO WORK; (from starting to finishing time i.e 10am - 11pm or open to close)

Do you possess a current RSA certificate? Yes/No (Please circle)

Do you possess a current RCG certificate? Yes/No (Please circle)

INDUSTRY SKILLS (Experience in TAB, KENO, BAR, ETC) ____________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

Do you have any medical and or social problem which might affect the performance of your work or the work of others?

                                                                                                                                        Yes/No (Please circle)

If YES, give details; _______________________________________________________________________________

Do you have any previous Workers Compensation/ Worcover claims in NSW or other States?

                                                                                                                                           Yes/No (Please circle)

If YES, what injuries:_______________________________________________________________________________

Do we have permission to check with Workcover ?                                                     Yes/No (Please circle)

Have you worked at the Goulburn Workers Club before?                                            Yes/No (Please circle)

If YES what position did you hold? _________________________________________________________________________

Have you ever applied for a job at the Goulburn Workers Club before?                      Yes/No (Please circle)

If YES When ? ________________________________________________________________________________________

Do you have friends or relatives working at the Club? ___________________________________________________________

                                                                                                                                                Yes/No (Please circle)

If YES, who ? _________________________________________________________________________________________

Is transport a problem if finishing late ?                                                                                Yes/No (Please circle)

Do we have permission to check with your pas employers ?                                            Yes/No (Please circle)

If answer is NO state reason: _____________________________________________________________________________

____________________________________________________________________________________________________

I UNDERSTAND THAT IF MY APPLICATION IS SUCCESSFUL I AM EMPLOYED ON A PROBATIONARY AGREEMENT (TWELVE WEEKS) AND AT THE END OF THIS PERIOD A FINAL DECISION ON MY EMPLOYMENT WILL BE MADE.

I UNDERSTAND THAT ANY FALSE, MISLEADING OR INCOMPLETE INFORMATION STATED BY ME ON THE APPLICATION WILL LEAD TO INSTANT DISMISSAL IF EMPLOYED BY THE CLUB.

I...................................................UNDERSTAND THAT AS A HOSPITALITY VENUE I AM EXPECTED TO WORK: EARLY MORNINGS, NIGHTS, PUBLIC HOLIDAYS AND WEEKENDS AS REQUIRED.

I DECLARE THAT THE ABOVE INFORMATION PROVIDED IS TRUE AND COMPLETE IN ALL ASPECTS.

APPLICANTS SIGNATURE:                                                                                            DATE:        /            /

___________________________________________________________________________________________________

OFFICE USE ONLY

Commencement Date: ___________________________________________Centre:

Title: ________________________________________________________ Award Level____________________________

Department: ________________________________________Full Time q Part Time q Casual q Rate $____________