top of page

Application For Employment

STATE
DATE OF BIRTH
Day
Month
Year
TITLE
ARE YOU AN AUSTRALIAN RESIDENT:
YES
NO

You will be required, if your application is successful, to provide proof of work rights before commencement of work.

EDUCATION:

EMPLOYMENT HISTORY:

HAVE YOU BEEN EMPLOYED AT D’ORSOGNA BEFORE?
YES
NO

LICENCE DETAILS:

(PLEASE PROVIDE DETAILS OF ANY LICENCES/CERTIFICATIONS YOU HOLD)

AVAILABILITY:

WHAT DAYS ARE YOU AVAILABLE?
WHAT TYPE OF WORK ARE YOU SEEKING?
DISCLOSURE OF PRE-EXISTING INJURY OR ILLNESS:
YES
NO

Do you have any pre-existing illness or injury which may impact on your ability to perform the inherent requirements of the position(s) for which you have applied? The inherent requirements may include repetitive physical actions including heavy lifting/pushing, above shoulder work, standing for long periods in a cold environment, requirement to wear issued PPE and safe handling of food products for human consumption.

Are you currently taking any form of medication that may impact on your ability to safely perform the inherent requirements of the position that you have applied for?
YES
NO
Have you ever made a claim for Worker’s Compensation that will impact on your ability to safely perform the inherent requirements of the role?
YES
NO
Are you prepared to have a pre-employment medical including drug and alcohol testing?
YES
NO
Do you agree to comply with vaccination requirements of the site?
YES
NO
Do you agree to overtime if required?
YES
NO

REFEREES:

DECLARATION:

Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.

COLLECTION STATEMENT:

The purpose of collecting your personal information is to determine your suitability for employment for the role that you have applied for. Your details are confidential and will not be used or disclosed for any other purpose. This form will be destroyed after three months from the date it was received unless an offer of employment has been made and accepted. Please read our Privacy Policy


DISCLAIMER:

For security, privacy, and compliance purposes, you are strictly advised not to submit any bank account details, Tax File Numbers, or other identification numbers through online forms, email communications, or any digital platform.

bottom of page