GENERAL INFORMATION

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PAYROLL AUTHORITY

For wages to be transferred into your bank account please complete the following

Please attach a copy of your Tax File Number Declaration Form

Primary Bank Account

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CHANGE OF INFORMATION

I (insert name below)

understand that (please tick boxes):

Breeze group Labour specialists must be advised immediately if there is any change of information relevant to this application form.The company must be advised immediately if the account to which my wages is deposited is closed or transferred to another Branch or Bank Institution.In the event of over payment through any error, Breeze group Labour specialists will retain the right to reclaim same.

Employee Signature:

SCHOOLING AND QUALIFICATIONS

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EMERGENCY CONTACT

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MEDICAL HISTORY AND WORKCOVER

Do you have any medical history or physical condition which may affect your performance of the inherent requirements? If yes, please detail bellow:

Are you currently or have in the past 5 years made any Workcover claims? Against your previous employer? (please tick one)

NoYes

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WORK EXPERIENCE

Last Employer

Previous Employer

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LICENSING INFORMATION

Please attach a copy of your Drivers License and/or Forklift License

Please attach a copy of your other license


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AGREEMENT

Breeze group Labour specialists are committed to providing a safe working environment for all employees. As a part of our recruitment process it is our objective to ensure potential employees are not required to work in duties that they are not able to perform safely, and we request that you disclose any pre-existing injury or disease which may be adversely affected by the performance of the inherent requirements of the position listed on the application.

According to the Accident Compensation Act which came to effect on 29th June 1998 you are required to disclose to Breeze group Labour specialists any pre-existing injury or disease that you have suffered of which you are aware and could reasonably be affected by the nature of the proposed employment referred to above.

Breeze group Labour specialists is an equal opportunity employer and will arrange any reasonable adjustment which will allow a person with a disability to perform the inherent requirements of the position and therefore compete equally with other applicants for the position.

I (insert name below)

confirm that I have read and understood the contents of the above from Breeze group Labour specialists and state that I have disclosed all relevant information below in relation to my health and physical ability to carry out this position.

Applicants Signature:

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UNIFORM CONSENT FORM

As a representative of Breeze group Labour specialists it is your full responsibility to maintain a professional standard of dress and grooming when working at any of our client’s facilities or locations. It is very important that you take care of your uniform, you must not intentionally damage or destroy any part of the uniform as you may be liable to replace them at your own expense, where uniforms are supplied. Health and safety laws require workers to not internally damage or destroy any items which are provided for safety reasons. This does not include any general wear and tear that may occur.

Please Note, failure to return uniform under any circumstances may result in a uniform cost deduction in your pay.

Where a client “standard” uniform is not required it is a responsibility for you to supply your own uniform, this will need to include but not be limited to safety boots, high visibility clothing and appropriate pants/shorts.

Please note, uniform not supplied by Breeze group Labour specialists or their clients must be plain and not have any other company markings or logos.


I (insert name below)

fully understand and agree with the above and am aware that I will receive a deduction in my pay from Breeze group Labour specialists to cover the full cost of the provided protective equipment when and if applicable.

POLICE CHECK AUTHORITY FORM

I (insert name below)

give written authority for Breeze group Labour specialists to request a Police check on my behalf. I do so with the intent that it is only used for employment background security checks.

100 Points of ID
YesNo

DISCLOSURE

Yes, I understand the details of the above application.Yes, I acknowledge that the information provided is true and correct at the time of this application.Yes, I authorise Breeze Group Australia to use the information supplied within this document to conduct the necessary checks in order to process this application.Yes, I authorise Breeze Group Australia to contact my previous employer references