07 5598 5228
15 Bienvenue Drive, Currumbin Waters, QLD 4223
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APPLICATION FORM
Application for Employment
Possition Applied
Date
MM slash DD slash YYYY
Type of position desired:
Permanent
Part-time
Casual
Please choose your availability to work:
Monday
AM
PM
Tuesday
AM
PM
Wednesday
AM
PM
Thursday
AM
PM
Friday
AM
PM
Saturday
AM
PM
Date available to commence work if successful__
Personal Details:
Title
(Required)
Mr
Miss
Mrs
Ms
Surname
(Required)
Firstname
(Required)
Preferred Name
(Required)
Address
(Required)
Postcode
(Required)
Home Phone
Work Phone
Mobile Phone
Email
(Required)
Are you a permanent resident of Australia or an Australian Citizen?
Yes
No
Are you over 18 years of age?
Yes
No
Next of kin name:
Relationship to you:
Next of kin phone number:
Qualifications:
QUALIFICATION GAINED
EDUCATIONAL INSTITUTION
YEAR COMPLETED
SKILLS CHECKLIST (please indicate those areas in which you are able to demonstrate skills/experience)
Tab
Poker Machines
Door/Reception
Tray service
Beverage service
Cashier
Cellar
Keno
Cleaning
Waiting
Employment History and References
Are you currently employed?
Yes
No
Current / Most recent employer
Position
Employed
From - To
Responsibilites
Name of supervisor / manager
Contact #
Reason for leaving
Health Record
Have you ever had any accidents or serious illness, either work related or personal?
Yes
No
If “Yes” please give details:
Have you ever received Workers Compensation?
Yes
No
If “Yes” please give details:
Are you aware of any health problem, which may affect your capacity to work?
Yes
No
If “Yes” please give details:
General
Have you ever had employment terminated due to unsatisfactory work or conduct?
Yes
No
If “Yes” please give details:
Have you, in the last five years, been convicted of any offence other than minor traffic infringements?
Yes
No
If “Yes” please give details:
Do you have any objection to enquiries of your present employment regarding qualifications and character?
Yes
No
If “Yes” please give details:
Is there any additional information you wish to provide?
Yes
No
If “Yes” please give details:
DECLARATION
I hereby authorise Club York to contact the persons above for the purposes of collecting reference information that relates to suitability for employment.
I declare that the information supplied in this application is, to the best of my knowledge both true and complete. I understand that providing false information may be sufficient cause for rejection or, in the case of employment, dismissal.
After having read the relevant material, I agree to abide by the Club’s policies and procedures as disclosed to me or contained in the staff manual, or any other manuals and documentation directly related to my employment.
I agree to complete all reasonable requests of Club York as directed by management. Including working in other areas or capacities than directly stated in my job description.
I understand that should this application be successful there will be a six (6) month probation period, during which, if the arrangement does not prove successful, my offer of employment may be rescinded.
Please complete only if you are successful:
Banking Details
(pays are processed on Wednesday and is normally cleared by the following day)
Bank Name
Name on Account
Account Number
BSB Number (6 Digit Number)