Date
/
Day
/
Month
Year
Consultant
Full Name
*
First Name
Last Name
Gender
Male
Female
Not Specified
Rating
Current Status
Birth Date
*
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Month
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Year
Postal Address
*
Street Address
*
Town
*
NSW
ACT
QLD
VIC
SA
WA
TAS
State
*
Postcode
Country
Are you registered with a Government job service provider? If yes;
Mission
MBC
ESG
Max Employment
Konekt
Nova
WISE
Contact Type
Contact
Mobile Phone Number
E-mail Address
Fax
Home Phone Number
-
Area Code
Phone Number
Emergency contact
Emergency Contact Person
Relationship
Surname
First Name
Mobile Phone Number
Other Phone Number
Emergency Contact Person Details
What Workcover Certificates/Licences do you have?
WC - White Card
LF - Forklift
First Aid
RSA
C - Car
I hold the following;
Other Workcover Certificates;
RCG
Confined Space
Dogman
Traffic Control
RTA BLUE/GREY CARD
RTA RED CARD
RTA ORANGE CARD
RTA YELLOW CARD
EWP
LB Backhoe
LE Excavator
LL Fronte end loader
LO Order picking LF
LS Skid steer/Bobcat
Asbestos
WH Working at Heights
Chemical Certificate
SECURITY
Vehicle Licence Class
C - Car
R - Rider
LR - Light Rigid
MR - Medium Rigid
HR - Heavy Rigid
HC - Combination
MC - Multi Combo
N/A
What sort of work are you after?
e.g. Labour, admin, warehouse etc.
What industries do you have experience in?
e.g. Construction, warehouse, admin, retail, hospitality etc.
Have you completed any trade qualifications?
e.g. Boilermaker, plumber, electrician etc.
Are you after full time hours or part time hours?
Full time
Part time
Have you ever been on Workers Compensation?
*
Yes, I have been on Workers Comp previously.
No, I have never been on Workers Comp.
If Yes, I have been on Workers Comp previously please provide details of injury.
How did you hear about us?
*
Website
Facebook
Google
Radio
Word of mouth
Yellow Pages
Jobsearch
Signage
Upload Resume
Browse Files
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of
Comments, additional experiences and skills
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Imported into Jupiter
Workcover Certs entered
Skills entered
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