Application For Employment
The Dubbo RSL Club Resort is an Equal Opportunity Employer. The information requested in this application form is required for us to enable a fair and equitable assessment process for all applicants. It is requested in accordance with the guidelines established in the relevant legislation in Australia.
Position/s Applied For: (required)
 
AVAILABILITY & PREFERENCE DETAILS
Please select the times you are available to work: PM = after 6:00pm
MON TUE WED THU FRI SAT SUN  
AM AM AM AM AM AM AM  
PM PM PM PM PM PM PM  
Type of employment sought Full-Time Part-Time Casual Holidays Other:
Date Available to Start
Other Comments
PERSONAL DETAILS
Title: Mr. Ms. Mrs. Miss Other:
First Name/s:
Surname:
Address:
Suburb:
State
Postcode:
Postal Address:
Suburb:
State
Postcode:
Home Phone:
Mobile Phone:
Email Address:
Date of Birth:
EMERGENCY CONTACT DETAILS
Name:
Address:
Suburb:
State
Postcode:
Relationship:
Home Phone:
Work Phone:
Mobile Phone:
GENERAL INFORMATION (please select)
Right to Work
I have the legal right to work in Australia because:
I am an Australian Citizen or I am a Permanent Resident or I hold a working visa
   
Criminal Offences
I have not been convicted of or have any criminal charges pending
I have been convicted of or have criminal charges pending  
Please provide details:
   
Previous Association with the Club
I have never previously worked for or applied for a job at the Dubbo RSL Club Resort
I have previously been employed by the Dubbo RSL Club Resort
Most recent position:
Date:
Left:
I have previously applied for a position with the Dubbo RSL Club Resort
Position applied for:
Date:
GENERAL HEALTH INFORMATION (please select)
INJURY - I have or have had an injury to the following :
Back Head Wrist/s Ankles/s
Neck Shoulder/s Hand/s Hip
Knee/s Elbow/s Finger/s Other:
Please provide details of the injury or treatment :
What is the current status of the injury?
   
ILLNESS - I suffer/have suffered from the following :
Blackouts Heart Disorders Arthritis Skin Disorders
Epilepsy Breathing Disorders Hernia Varicose Veins
Migraines Asthma Allergies Other:
Please provide details of the illness, the treatment and/or medication:
What is the current status of the illness?
   
HEARING - What is the status of your hearing?
Normal Not Normal
   
Please provide details as to the current status of your hearing:
   
SMOKING
I have never smoked I have smoked in the past, but have since given up the habit I currently smoke
WORK RELATED REFEREE DETAILS (do not list relatives)
I authorise the Dubbo RSL Club Resort to contact the following referees to obtain information in relation to my previous work performance prior to an offer of employment. Neither referee given below is a relation
Name:
Company:
Position
Phone Number:
   
Name:
Company
Position
Phone Number:
EDUCATION DETAILS
Secondary Education: Completed Year 9 Year 10 Year 11 Year 12 Other:
Responsible Service of Alcohol Responsible Conduct of Gambling
Date: Date:
 
Institution: Started:
Qualification: Completed:
 
Institution: Started:
Qualification: Completed:
 
Institution: Started:
Qualification: Completed:
 
Institution: Started:
Qualification: Completed:
EMPLOYMENT HISTORY
Most Recent Position Full-Time Part-Time Casual
Company Started:
Reason For Leaving Finished:
 
Prior Position Full-Time Part-Time Casual
Company Started:
Reason For Leaving Finished:
 
Prior Position Full-Time Part-Time Casual
Company Started:
Reason For Leaving Finished:
 
Prior Position Full-Time Part-Time Casual
Company Started:
Reason For Leaving Finished:
 
Prior Position Full-Time Part-Time Casual
Company Started:
Reason For Leaving Finished:
I authorise the Dubbo RSL Club Resort (the Club) to obtain, from any person, information in relation to my suitability for employment at the Club. I release any such person, firm or institution from liability for any damage, claims, costs or expenses which may arise from the provision of such information. I expressly authorise the Club to use any information provided by me in relation to my application for employment with the company to assess my suitability for employment. This includes, but is not limited to the information provided on this application form and the attached resume, as well as information obtained from a reference check. I consent to undertaking any numerical or verbal testing as may be required by the Club. I also consent to undertaking a pre-employment medical, which may include a urinary drug screen, if requested and consent to the release of medical information to the Club. In addition, I authorise the Club to use the same information for any purpose related to my future employment prospects with the Club. I authorise the Club to give part or all of the information I have supplied to the Club to an external recruitment agency of the Club’s choice if they choose to do so. I confirm that the information provided is accurate in every material respect. I acknowledge I have a right to access and respond to any information which I consider to be inaccurate. I also acknowledge that my application may be rejected or I may be summarily dismissed if any of the information provided by me is in any way inaccurate or misleading in any respect material to my employment with the Club.
Applicant Must Complete This Section
Name: (required)
  Select Yes to agree, No to disagree
Date:

 

© Copyright, Dubbo Memorial RSL Club, 2004, ACN. 000965355