Employment Application Form (Page 2 of 2) in pdf

Employment Application Form Page 2

Previous Employment: Please list employment you have had in the last 2 years:

Referees: Please supply the name/s of your previous employer or someone we can speak to for a character

reference (School Teacher, Justice of the Peace etc)

Referee Name:

Phone No:

Relationship:

Referee Name:

Phone No:

Relationship:

Applicants History

Please circle

Do you have any physical reasons or impediments which might, in any way, hinder your

ability to perform the job for which you have applied (example of tasks: lifting objects,

Yes

performing repetitive tasks, kneeling, crouching, standing for periods of time)?

Have you had any recent or past illnesses, operations or injuries which might, in any way,

Yes

hinder your ability to perform the job for which you have applied?

Do you have a legal right to work in Australia?

Yes

Have you, since the age of 18, ever been convicted of crime?

Yes

Are you willing to provide the Beechworth Bakery with a personal police clearance check

Yes

before your employment or at anytime during your employment with the Bakery?

Applicant Statement: “ The information I have provided is true and accurate”

Applicant Signature:

Date:

Employment Application Form Page 2