MANUAL EMPLOYMENT APPLICATION FORM

WHAT POSITION ARE YOU APPLYING FOR:

Position Title: Location:

YOUR DETAILS:
First Name: Surname:

Address:

Suburb: State: Post Code:

Phone Number: Mobile Number:

Email:
REFEREE DETAILS:
Referee Name: Referee Title: Company: Contact Number:

Do you give Interrelate permission to contact the above nominated referees for a verbal reference? Yes No
OTHER DETAILS:
Do you hold a current NSW driver's licence? Yes No
Have you worked for Interrelate before? Yes No
After reading more about the responsibilities of the position in the advertisement, do you have any injuries or
conditions which would prevent or impinge on your ability to undertake the inherent requirements of the postition? Yes No
Will you be working under a VISA? Yes No

Do you consent to a standard internet search? Yes No

Do you consent to a National Police Check? Yes No
Do you hold a current NSW Working with Children Check Clearance? Yes No
Note: As of 15th June 2013 the legislation for WWC checks changed for more information please visit the Commission for Children & Young People's website
http://www.kids.nsw.gov.au/

WWC Check Clearance Number: WWC Expiry Date:

Format DD/MM/YYYY
Where did you see our advertisement?

Do you identify from an Aboriginal and/or Torres Strait Islander background?

In submitting your application manually, please ensure you include with this form:
- your resume
- a brief cover letter
- a document responding to each of the selection criteria individually regarding how you can satisfy them (from the advertisement)

APPLICANT DECLARATION:
I declare that the above information provided by me on this Employment Application Form is true and correct.

I Agree
Manual Employment Application form