Application Form – Eazy Recruitment

Section 1 - General Information

Personal Information

Contact

Drivers Licence

Do you have a Driver’s Licence?I have a Driver's Licence.
Do you have a personal vehicle for work?I have a personal vehicle for work.

What is your class and Driver’s Licence Number?

Emergency Contact

You must provide this information

Section 2 - Personal Information

Right To Work

If you can not provide satisfactory evidence of your right to work in Australia, you will be required to sign a consent form to allow Eazy Recruitment Pty Ltd to check your right to work with the Department of Immigration and Multicultural Affairs.

Please select your currently work right status

Aboriginal or Torres Strait Islander descent

The Australian Government asks us to provide information about our employees when working on Government sites. Accordingly we are required to ask: Are you of Aboriginal or Torres Strait Islander descent?
YesNo

Medical

This part of the application process is in the interest of preventing workplace injuries and illness. This information enables to take into consideration your medical history and physical capabilities when placing you into a position or contracting you to a client. This information you are providing will be kept in strict confidence in compliance with privacy legislation. Eazy Recruitment Pty Ltd is committed to compliance with relevant anti- discrimination legislation. The information you provide is not for the purpose of determining the success of your application.

Please answer Yes or No to the following questions:

Are you prepared to undergo a Pre-Employment Medical Examination?
YesNo

Are you prepared to undergo a Drug and/or Alcohol Analysis/Testing, either random or scheduled?
YesNo

Please tick the boxes	Tick	Comment
Are you able to carry out strenuous tasks? E.g. lifting etc.	Yes
Are you able to work standing for long periods?	Yes
Can you work in a dusty environment?	Yes
Can you work at heights?	Yes
Are you able to do repetitive work?	Yes
Can you work in cold and wet conditions?	Yes
Are you able to work with solvents, oils, grease, resins?	Yes

Have you ever had any work related or non work related injuries, illnesses, operations, medical treatments, hearing loss etc?

Date	Injury/Illness	Treatment/Status

Are you aware of any medical conditions that may prevent you from performing the duties of the position to which you are applying?

If YES please provide details here:

Do you have any medical conditions which may prevent you from wearing approved personal protective safety equipment including (but not limited to) steel cap safety boots, eye protection, ear protection, hard hats, safety vests, safety harness?

If YES please provide details here:

Are you currently using any regular medication, prescribed or unprescribed?

If YES please provide details here:

Are you allergic to anything?

If YES please provide details here:

Medical Assessment Declaration

Do you declare that the above information provided concerning your state of Health and Physical Fitness is true and complete, is correctly and fully recorded, and that no information has been withheld or omitted concerning your past or present state of health or habits?

Do you understand that if you are accepted for employment and that if any information is found to be false or misleading or any material facts are suppressed, it may lead to the termination of your Contract or your Contract will be terminated

the prevention of workplace injuries and illness and for the purpose of meeting WHS obligations. The information you provide will be kept in strict confidence, although in cases where the information provided must be disclosed to the owner of premises where you are placed to work for the purpose of managing WHS obligations, the relevant information will be released to them for that purpose only and in the strictest confidence. Eazy Recruitment Pty Ltd advises that it will only use the information you provide for necessary purposes in accordance with Privacy Laws, Anti- Discrimination Legislation and WHS Laws.

Section 3 - Employment History

Employment History/Contactable Referees

At least TWO referees MUST be supplied.

All referees supplied MUST be recent and contactable.

Please ensure all referees have been forewarned.

Referee 1

Referee 2

Section 4 - Payroll

Bank Details

Please provide banking details for Electronic Funds Transfer (EFT) of wages to your bank account.

PLEASE NOTE – A Card number IS NOT SUITABLE, BSB numbers are 6 digits long

Superannuation

Depending on your employment arrangement with Eazy Recruitment Pty Ltd, you may qualify for Super Choice. A Super Choice Form will be provided to you during your registration. If you do not make a choice, Eazy Recruitment Pty Ltd will pay you Superannuation contributions to the default fund nominated on the form. If you do not qualify for Super Choice, Eazy Recruitment Pty Ltd will contribute your Superannuation to the required fund as set out in your employment arrangement.

Payslips

This section must be completed to receive payslips and payment summaries.

Please note that pay slips will be sent to YOUR email address ONLY.

APPLICANT’S DECLARATION

I,

knowingly declare that the information supplied by me concerning my registration to the best of my knowledge is true and accurate.

I understand that if any of the information is false or misleading, or material facts have been suppressed, I may be legally liable for damages, will not be considered for employment, or if I am employed, my employment may be terminated.

Click here to view and download Eazy Recruitment Induction Handbook

I have downloaded, read & understood the contents of Eazy Recruitment induction handbook, including company policies and procedures.

I consent to personal and sensitive information about me being collected, used and stored in relation to my placements. I further understand that Eazy Recruitment Pty Ltd may communicate either verbally or in writing with my previous employers, and or nominated educational institutions to authenticate contracting history and or stated qualifications. I understand that the collection, use and storage by Eazy Recruitment Pty Ltd of my personal and sensitive information is in compliance with the Federal Privacy Act 1988 and Privacy Amendment (Private Sector) Act 2000.

DECLARATION
Yes, I agree