Application For Employment (Page 3 of 4) in pdf

Have you worked shifts before?

YES/NO

Are you prepared to work shifts if required to do so?

YES/NO

Are you prepared to work additional hours due to seasonal requirement if required?

YES/NO

General:

Do you have any present criminal convictions, not including any concealed under the Clean Slate

Act?

YES/NO

Are you awaiting the hearing of charges in a civil or criminal court of law?

YES/NO

Have you been the subject of a diversion ordered by the courts?

YES/NO

Do you have a spouse, partner, relative or household member working here or elsewhere in

the industry?

(If yes please indicate below whom they are where they work and the position they hold)

YES/NO

_____________________________________________________________________________________

Do you know anyone that is currently working at this store?

(If yes please indicate below whom they are

and the position they hold)

YES/NO

____________________________________________________________________________________

Have you worked for New World Albany or an associated company previously?

YES/NO

If so, when was this: ______________________________Position: _____________________

Reason for

leaving:____________________________________________________________________

Do you have a current drivers licence? YES/NO

If yes, what class / s? ___________

What transport arrangements do you have to be able to attend work

? (E.g. own car / public transport /

walk)

______________________________________________________________________________________________

What are your interests/hobbies/sports/clubs or community activities?

_____________________________________________________________________________

Medical

(It is important that all questions in this section are answered fully)

Have you had an injury or medical condition caused by gradual process, disease or infection (e.g.

hearing loss, sensitivity to chemicals, repetitive strain injuries), that may be aggravated or further

contributed to by the tasks of the job you are applying for?

(If yes, please give details below)

YES/NO

_____________________________________________________________________________

Do you suffer from any injury, ailment or other disability, or medical condition, which may adversely

affect your regular attendance at work or adversely affect your work performance?

(If yes, please give details below)

YES/NO

_____________________________________________________________________________

If you are offered employment, the offer may be made subject to your obtaining a full medical clearance (by

completion of medical examination) to assess your fitness for the job for which you are applying

Application For Employment Page 3

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