Please enable JavaScript in your browser to complete this form.Personal DetailsName *FirstLastHome PhoneMobile *Date of Birth *Address *Address Line 1Address Line 2CityState / Province / RegionPostal CodeEducation DetailsHighest Education Level Attained *Year 11 or below (includes Certificate I/II/nfd)Year 12Certificate III/IVAdvanced Diploma and DiplomaBachelor Degree Graduate Diploma and Graduate CertificatePostgraduate DegreeCertificate III/IV Course Name *Diploma/Advanced Diploma Course Name *Bachelor Degree Course Name *Graduate Diploma/Graduate Certificate Course Name *Postgraduate Degree Course Name *Other Studies & CoursesCurrent/Previous Employment DetailsIs this role? *CurrentPreviousBusiness Name *Position *Location *Employed From Date *Employed To Date *IncomeIncome periodPer WeekPer YearTo whom did you report? *Your Direct Manager's Phone Number *May we contact them at the proper time? *YesNoPrevious Employment Details #2Business Name (Details #2)Position (Details #2)Location (Details #2)Employed From Date (Details #2)Employed To Date (Details #2)Income (Details #2)Income Period (Details #2)Per WeekPer YearTo whom did you report? (Details #2)Your Direct Manager's Phone Number (Details #2)May we contact them at the proper time? (Details #2)YesNoPrevious Employment Details #3Business Name (Details #3)Position (Details #3)Location (Details #3)Employed From Date (Details #3)Employed To Date (Details #3)Income (Details #3)Income Period (Details #3)Per WeekPer YearTo whom did you report? (Details #3)Your Direct Manager's Phone Number (Details #3)May we contact them at the proper time? (Details #3)YesNoWorkers Compensation ClaimsPlease Note: People with workers compensation claims history are not automatically excluded from applying for this position. Each applicant will be considered on their merits.Have you ever made any workers compensation claims? *YesNoHow many claims have you had in the last five (5) years?1233+Claim #1Claim #1 - Date of ClaimClaim #1 - Nature of Claim & InjuryClaim #1 - Work Days LostClaim #1 - Are you fully recovered?YesNoClaim #1 - EmployerClaim #1 - Insurance CompanyClaim #2Claim #2 - Date of ClaimClaim #2 - Nature of Claim & InjuryClaim #2 - Work Days LostClaim #2 - Are you fully recovered?YesNoClaim #2 - EmployerClaim #2 - Insurance CompanyClaim #3Claim #3 - Date of ClaimClaim #3 - Nature of Claim & InjuryClaim #3 - Work Days LostClaim #3 - Are you fully recovered?YesNoClaim #3 - EmployerClaim #3 - Insurance CompanyFurther ClaimsPlease bring details of these claims with you.HealthDo you have, or suspect that you have any illness, medical condition, injury or disability that would impact your capacity to perform the position being applied for on this application or would be aggravated by the duties you will be required to perform? *YesNoIf you are a Queensland employee: I hereby consent to the Company applying to Workcover for a copy of my workers compensation claims history *YesNoCriminal OffencesPlease Note: People with criminal records are not automatically excluded from applying for this position. Each applicant will be considered on their merits.Have you, in the last 5 years, been convicted of a criminal offence? *YesNoPlease give detailsI hereby consent to the Company conducting a National Criminal History Records Check? *YesNoDriving RequirementsIs driving a requirement for this position? *YesNoLicence No. *Licence Class *State of Issue *QueenslandNew South WalesVictoriaSouth AustraliaWestern AustraliaNorthern TerritoryTasmaniaHas your licence ever been cancelled or endorsed? *YesNoHave you in the last 5 years been convicted of any driving offences? *YesNoPeople with driving convictions, offences or who have been involved in accidents are not automatically excluded from applying for this position. Each applicant will be considered on their merits.How many driving offences have you had in the last five (5) years?1233+Driving Offence #1Date (Offence #1)Type of offence (Offence #1)?AccidentConvictionNature of Accident (Offence #1)Who was at fault? (Offence #1)MyselfOther DriverNature of Conviction (Offence #1)Driving Offence #2Date (Offence #2)Type of offence (Offence #2)?AccidentConvictionNature of Accident (Offence #2)Who was at fault? (Offence #2)MyselfOther DriverNature of Conviction (Offence #2)Driving Offence #3Date (Offence #3)Type of offence (Offence #3)?AccidentConvictionNature of Accident (Offence #3)Who was at fault? (Offence #3)MyselfOther DriverNature of Conviction (Offence #3)Further Driving OffencesPlease submit further driving offences to HR upon employment.Forklift LicenceDo you have a Forklift Licence? *YesNoForklift Licence DetailsForklift Licence ClassLFLOYears of experience1233+Thanks for applying for a role at APG. We'll be in touch if your application is success for a role.Submit
