Male / Female / Other
Date of Birth
Days Available for Work
Drug and Alcohol Screening
Some of our clients may require that persons placed with them are subject to random drug and/or alcohol tests. If this applies, do you consent to undertaking such tests?
Criminal History Check
Some of our clients may require that persons placed with them are subject to a criminal history check. If this applies, do you consent to undertaking such tests?
The State based workers compensation legislation provides that any recurrence, aggravation, acceleration, exacerbation and deterioration of a pre-existing injury or disease resulting from the proposed employment will not entitle you to compensation where you have failed to disclose or have made a false or misleading disclosure. In signing this form you acknowledge that you will advise us in writing of: 1. Any pre-existing injuries and illnesses that may be affected by any proposed employment offered to you and /or may put you or others at risk. 2. Any reason why you may not be fit to perform the inherent requirements of the proposed employment offered to you.
