Job Application Form - Gippsland, VIC

Job Application - Gippsland, VIC

Careers

The company has committed to the local community and industry with jobs for skilled locals who are keen to pursue a career in the meat processing industry whilst embracing the values of Safety, Integrity, People, Ideas and Community. Please carefully fill in the application form.

Job Application Form - Gippsland, VIC

Education

EDUCATION AND QUALIFICATIONS

Name of School, College, University,etc	Dates Attended From: To:		Qualifications Obtained
School	From	To	Qualification
School	From	To	Qualification
School	From	To	Qualification
School	From	To	Qualification
School	From	To	Qualification

TRADE / OCCUPATIONAL QUALIFICATIONS

Please list trade/occupational qualifications : (Where appropriate, you will be required to produce original documents)

Are you currently studying or planning to study for any qualifications ?	Yes No
If requested, are you willing to undertake training during and/or outside business hours ?	Yes No

Q Fever

Identification & Q Fever Inoculation

I have obtained and currently hold a valid licence/Qualifications (Proof will be Required)
Licence	Licence number	State obtained	Date obtained	Expiry Date
Drivers Licence	Drivers Licence Number	Drivers State Obtained	Drivers Date Obtained	Drivers Expiry Date
Forklift licence	Forklift Licence Number	Forklift State Obtained	Forklift Date Obtained	Forklift Expiry Date
Heavy Rigid	Heavy Rigid Licence Number	Heavy Rigid State Obtained	Heavy Rigid Date Obtained	Heavy Rigid Expiry Date
First Aid	First Aid Licence Number	First Aid State Obtained	First Aid Date Obtained	First Aid Expiry Date
Other	Other Licence Number	Other State Obtained	Other Date Obtained	Other Expiry Date

Q fever

Have you ever had, or been vaccinated against Q fever ?	Yes No
If yes what is your register number
Are you prepared to be vaccinated against Q fever ?	Yes No

There have been several cases in Victoria where employees have contracted Q fever while working at red meat plants. It is therefore a requirement that all staff be immunised prior to commencing work with the company. On successful application, unless you have been vaccinated against Q fever, you will be required to go through the immunisation process with our preferred medical practitioner.

If you have any queries regarding the Q fever immunisation please contact the HR Personnel Officer.

If you have been immunised against Q fever proof of vaccination will need to be provided.

Interests

Please advise what, if any, knowledge of meat industry you possess. Set out here any experience you may have of work in the industry knowledge of livestock


PERSONAL INTERESTS / HOBBIES please list: Personal Interests / Hobbies

Health

Health & Safety

You are seeking employment with Greenham Gippsland as a
	title/name of job

This position may involve activities including lifting, pulling, pushing, holding and carrying items and product weighing in excess of 10 kilograms. The position may also involve labour intensive duties as part of a team of production employees to produce the final red meat related product. In the red meat industry manual handling covers a wide range of activities such as slaughtering, boning, rendering, wrapping & packing. These activities may involve:

Repetitive or sustained application of force
Repetitive or sustained awkward posture
Repetitive or sustained movement
Application of high force
Manual handling issues handling a live animal
Packing & handling of boxed meat

As detailed above some of the work activities at Greenham Gippsland can involve physically demanding tasks. Given this, please give details of any health or physical problems which may affect you work performance ?


Are you prepared to wear/use all safety equipment supplied by the company ?	Yes No
Have you ever worked Abattoir before ?	Yes No
Do you have any experience in using a knife ?	Yes No

Please provide details if you have ever been affected by the conditions listed below: -

Item		Details	Date Last Affected
Asthma, Bronchitis or Emphysema	Yes No
High Blood pressure, Stroke or Heart Condition	Yes No
Diabetes or Kidney Disease	Yes No	Diabetes or Kidney Disease Details
Hernia	Yes No	Hernia Details	Hernia Date Last Affected
Migraines, Epilepsy or Blackouts	Yes No
Joint or Muscular Complaint	Yes No	Joint or Muscular Complaint Details
Back Condition or Injury	Yes No	Back Condition or Injury Details
Allergies	Yes No	Allergies Details	Allergies Date Last Affected
Skin Conditions (i.e. Eczema, Dermatitis)	Yes No
Eye Conditions	Yes No	Eye Conditions Details	Eye Conditions Date Last Affected
Stress	Yes No	Stress Details	Stress Date Last Affected
Hearing loss	Yes No	Hearing loss Details	Hearing loss Date Last Affected
Major Operations	Yes No	Major Operations Details	Major Operations Date Last Affected

Have you had, or do you suffer from:		If YES, Give Details
Allergies	Yes No	Allergies Details
Are you taking drugs or other medication	Yes No	Drugs Details
Any illness that may disallow you from working in the food industry (ie: Hepatitis)	Yes No	Illness details

*Surname :**
*First Names :**
Address :
Telephone Numbers :	Home :	Mobile :
Date of Birth : (dd/mm/yyyy)		Sex	Male Female
*Email :**
Marital Status :		Number of Dependants
Name of Emergency Contact :		Emergency Contact No

Do you hold a current Motor Vehicle License :	Yes No
Do you hold any other current Licenses/tickets :	Yes No
Please specify
Do you have your own transport :	Yes No
Are you an Australian, a New Zealand citizen, or a permanent resident? State which :
What is your eligibility to work in Australia ? * Please click one of the following:
Citizen of Australia Citizen of New Zealand Permanent residency Visa sub class Permanent working rights other Visa sub class Temporary working rights other Visa sub class Other
What type of Visa and Subclass do you hold ?
You will be required to produce documentary evidence to substantiate the above information. Such evidence as passport(s), visa(s), certificate of citizenship, birth certificate, drivers license, etc. or a combination there of.
If you are not an Australian or New Zealand citizen and you do not have the right of permanent residency here, we are required to ask the following question:
Do you have a work permit ?	Yes No
If Yes, you will need to produce your passport for verification

List your most current employer first.
Current / Past Employer		Contact number
Position	From	To
Reason for leaving

Current / Past Employer		Contact number
Position	From	To
Reason for leaving

Current / Past Employer		Contact number
Position	From	To
Reason for leaving

Current / Past Employer		Contact number
Position	From	To
Reason for leaving

May we discuss references with past employers ? Yes No

In addition to past employers, please give names and contact numbers of two non-work related persons who will provide references:

Name		Contact
Name		Contact


Superannuation will be paid into the company’s employee industry fund unless you prefer your own choice of superfund.

Are you a Member of a Superannuation Fund ?	Yes No
If yes, provide details of the fund to which contributions are to be remitted:
Name :
Address and Details :

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Job Application - Gippsland, VIC

Job Application - Gippsland, VIC

Job Application Form - Gippsland, VIC

Personal

PERSONAL INFORMATION

Education

EDUCATION AND QUALIFICATIONS

TRADE / OCCUPATIONAL QUALIFICATIONS

Q Fever

Identification & Q Fever Inoculation

Q fever

Interests

Employment

EMPLOYMENT RECORD

REFEREES

SUPERANNUATION

CONDITIONS OF EMPLOYMENT

Health

Health & Safety

Terms

Terms

UPLOAD CV/RESUME, DRIVERS LICENCE & ELIGIBILITY TO WORK IN AUSTRALIA DOCUMENTS HERE

Do you agree to work overtime as and when required ?	Yes No
Do you agree to attend a Doctor nominated by the company for a pre-employment medical examination ( if required ). The medical examination may include a urinary drug screening as part of your employment application process ?	Yes No
Do you agree to abide by the Company Rules and Procedures ?	Yes No
Are there any restrictions on your availability to do shift work ?	Yes No
Are there any restrictions on your working overtime ?	Yes No
Have you ever applied for a position or worked at Greenham Gippsland in the past ?	Yes No
Have you had any criminal convictions in the past 10 years ?	Yes No
If your application is successful, when could you start work?
Day :	Date :(d/m/yyyy)

Is your hearing normal ?	Yes No
Have you ever worked in a noisy environment ?	Yes No
Has your hearing been affected by noise ?	Yes No
Is your eyesight good for all usual activities ?	Yes No
Do you wear glasses/contact lenses ?	Yes No
Further Details if needed :

Have you ever been refused life insurance, a job or military service because of poor health ?	Yes No
Please detail any Workers Compensation and Transport Accident claims resulting from work and non-work injuries ?

How did you find out about employment at Greenham Gippsland?
Employment Agency		Seek.com.au
Latrobe Valley Express		Greenham Website
Warragul Drouin Times		Beef Central
Adzuna		Footy Club
Word of Mouth		Friend / Family
Facebook

In making this application for employment to this position you are required to disclose any (all) preexisting injuries or diseases suffered by you, which you reasonably believe could be affected by you undertaking this position, the details of which are set out above. If you fail to disclose this information or if you provide false or misleading information you and your dependents may not be entitled to WorkCover benefits in the event of any recurrence, aggravation, acceleration, exacerbation or deterioration of the pre-existing injury or disease, arising out of, or in the course or due to the nature of this employment with Greenham Gippsland.

	I acknowledge that I have read and understood the above statement and declare that the answers to the questions in this application are true and correct *
	I accept that should my application be successful, the foregoing information will form part of my contract of employment and falsification or omission of information are ground for summary dismissal
	I have agreed to supply the information on a confidential basis between myself and my prospective employer, who may make any necessary inquiries to satisfy themself about the application *