Pioneer Facility Services – Employment Site – Pioneer Facility Services Employment Site

Position Applied For*

Personal Information

Name*

First Middle Last

Preferred Name

Address*

State*

Postcode*

Email Address*

Mobile*

Emergency Contact

PERSON TO CONTACT IN CASE OF EMERGENCY

Name*

Address*

Contact number*

Education

Education*

ORIGINAL CERTIFICATES NEED TO BE SIGHTED AND PHOTOCOPIED (WHERE APPLICABLE)

Schools, Colleges and Universities Attended	From	To	Full Time or Part-Time	Please Supply Details (e.g. VCE / HSC)

Trade or professional qualifications (show dates gained)

Member of relevant professional bodies, associations

Education certificates

Attach certificates here

Drop files here or

Max. file size: 64 MB.

Employment History

Last or present position

Employer's name

Address

Position held

Held from

Held until

Reason for leaving

Key duties and responsibilities

Any other company where you have worked for three years or more

Employer's name

Address

Position held

Held from

Held until

Reason for leaving

Key duties and responsibilities

Have you worked for Pioneer Facility Services before?*

Where?*

Who was your manager?*

Verification of identity and entitlement to work in Australia

PLEASE ATTACH ONE (1) OF THE FOLLOWING DOCUMENTS. N.B. THE DOCUMENT WILL BE SIGHTED AND PHOTOCOPIED

AUSTRALIAN OR NEW ZEALAND PASSPORT
AUSTRALIAN DRIVER’S LICENCE
ORIGINAL BIRTH CERTIFICATE
OVERSEAS PASSPORT WITH VISA DETAILS “HOLDER(S) PERMITTED TO REMAIN IN AUSTRALIA INDEFINITELY”
OVERSEAS PASSPORT WITH CONFIRMATION OF A CURRENT TEMPORARY WORK VISA AND ITS EXPIRY DATE

Attach document here

Max. file size: 64 MB.

Criminal history check

RELEVANT FOR EMPLOYMENT OF CERTAIN CATEGORIES OF EMPLOYEES, e.g. CASINO EMPLOYEES, HEALTH CARE, CHILD CARE, DISABILITY SERVICE PROVIDERS, FINANCIAL SERVICES, DEFENCE SITES

Have you ever been convicted of a criminal offence?*

Which one(s)?*

*FOR YOU TO BE CONVICTED, A COURT WOULD HAVE TO HAVE MADE A FINDING THAT YOU WERE EITHER:

CONVICTED BY A SINGLE JUDGE OR JURY OF THE OFFENCE
GUILTY OF THE OFFENCE(S) CHARGED BUT DISMISSED WITHOUT A CONVICTION

THE CONVICTION WILL BE SPENT IN THE FOLLOWING CIRCUMSTANCES WHICH MEANS THAT YOU DO NOT HAVE TO MENTION IT: [ACCORDING TO THE LEGISLATION APPLYING IN YOUR STATE OR TERRITORY, THE TYPE OF EMPLOYER YOU ARE, AND INDUSTRY IN WHICH YOU OPERATE, INDICATE WHEN A CONVICTION WILL SAID TO BE SPENT IN THE CIRCUMSTANCES PERTAINING TO YOUR BUSINESS].

Medical Information

Health or medical conditions

DO YOU HAVE ANY HEALTH PROBLEMS OR A MEDICAL CONDITION WHICH MAY AFFECT YOUR ABILITY TO PERFORM THE REQUIREMENTS OF THE POSITION [AS SPECIFIED ABOVE OR IN THE POSITION DESCRIPTION ATTACHED TO THIS APPLICATION?]

Medical examination*

WOULD YOU AGREE TO UNDERGO A MEDICAL EXAMINATION TO ASSESS YOUR SUITABILITY TO BE ABLE TO CARRY OUT THE REQUIREMENTS OF THE POSITION?

Referee List

Referees

Name of referee	Position held	Contact telephone number

ARE THERE ANY OTHER DETAILS RELEVANT TO THE POSITION YOU ARE APPLYING FOR WHICH YOU WOULD LIKE US TO CONSIDER?

I UNDERSTAND THAT ALL OFFERS OF EMPLOYMENT ARE CONDITIONAL UPON SATISFACTORY REFERENCE AND BACKGROUND CHECKS BEING OBTAINED (INCLUDING CRIMINAL RECORD AND PRE-EMPLOYMENT MEDICAL CHECKS, AS RELEVANT AND REQUIRED FOR THE POSITION), AND THE PRODUCTION OF ALL DOCUMENTS NECESSARY FOR [THE COMPANY] TO VERIFY MY IDENTITY, QUALIFICATIONS AND ABILITY TO WORK IN AUSTRALIA. I CONSENT TO THE AUTHORISED REPRESENTATIVES OF THE COMPANY CONTACTING ANY PERSON(S) OR INSTITUTIONS RELEVANT TO THIS APPLICATION TO UNDERTAKE THESE VERIFICATIONS AND CHECKS.

I CERTIFY THAT THE INFORMATION PROVIDED IN THIS APPLICATION IS TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE, INFORMATION AND BELIEF. I UNDERSTAND WITHHOLDING PERTINENT INFORMATION OR SUBMITTING FALSE OR MISLEADING INFORMATION ON THIS APPLICATION, MY RESUME, DURING INTERVIEWS OR AT ANY OTHER TIME DURING THE HIRING PROCESS, MAY RESULT IN MY DISQUALIFICATION FROM FURTHER CONSIDERATION FOR EMPLOYMENT OR, IF I AM EMPLOYED, THE TERMINATION OF MY EMPLOYMENT.

Signature*

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APPLICATION FOR EMPLOYMENT