Candidate Registration Form
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1
2CANDIDATE REGISTRATION FORM
(Please Print Neatly)
Today’s date:
CANDIDATE ID #
PERSONAL DETAILS
Surname
First:
Middle:
Date of Birth:
Mr.
Miss
Mrs.
Ms.
/
/
Street address:
City:
Post Code:
Home phone no.:
Mobile:
Resume/CV Provided?
(
)
Yes
No
Email:
Have you had a Police Check conducted in the last 12 months?
Yes
No
Do you have a working with Children’s Check?
Yes
No
Do you have any pre- existing injuries and / or diseases which might be
Yes
No
If Yes Please Specify:
affected by the nature of the proposed employment sought?
PRE Existing Injury Declaration
- Accident Compensation Act 1985 Section 82 (7-9).
I acknowledge that any non disclosure or false or misleading information on my part may result in Section 82(8) of the Accident Compensation
Act being applied which would disentitle me or my dependants from receiving benefits relating to any recurrence, aggravation, acceleration,
exacerbation or deterioration of any pre-existing injury or disease which I may have.
Car (Probationary/Full)
Current Drivers Licence:
Licence #:
Expiry date:
Are you willing to travel?:
Yes
No
Do you have your own transport?
Yes
No
EMPLOYMENT PREFERENCES
Temporary
Permanent
Full Time
Part Time
_______________Hours
Current Salary:
Desired Salary:
Temp Hourly Rate:
PLEASE LIST TYPE OF EMPLOYMENT YOU ARE INTERESTED IN
Administration
Accounts Payable/Receivable
Warehousing
Customer Service
Reception
Management
Truck / Forklift Driver
Labourer
Bookkeeping
Accounting
Hospitality
Other ___________________
Notes:
ACKNOWLEDGEMENT- DECALRATION AND PRIVACY ACT CONSENT
If you have not found a job in six months after you register with Monarch Personnel, you will need to confirm with our office that you are still
available. Failure to do so may result in your data being removed from our database and information destroyed..
I declare that the information above, including my résumé, is true and accurate and I agree that the referees listed may be contacted by Monarch
Personnel, and I further agree to provide a Disclaimer of Liability for all parties involved in the reference checking process.
I have read and understood Monarch Personnel’s Privacy Policy, Collection Statement and Consent to Electronic Transactions.
I consent to Monarch Personnel using my personal information for the purposes described in the policy and statement. I consent to my personal
information being disclosed to individuals or organisation listed in these statements.
Applicants with a working visa or who have become an Australian Citizen: I give Monarch Personnel permission to verify with the Department of
Immigration and Citizenship, my legal entitlement to work in Australia.
Signature:
Date:
Registration Form 2012R:\RECRUITMENT OPERATIONS\Templates\Registration Form 2012.docx
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