INSELEC Group

Registration Form

PERSONAL DETAILS

* First Name

* Surname

* Date of Birth

* Height (CM)

* Weight (KG)

* Street Address

* Suburb

* State

* Post Code

Phone

* Mobile

Mobile 2

* Email

* Send payslip to this email?

Yes

Do you have another address? If yes please include the full address below:

Are you registered with Centrelink and have been in receipt of JobSeeker payment, Youth Allowance, Parenting Payment or other allowances for at least 1 month within the past three months before this position?

If "Yes", Indicate which one:

JOBACTIVE

* Are you registered with a Jobactive Service Provider such as Max Employment or Salvation Army Employment? If so, please give you details as this may assist in receiving extra funds for you to pay for things such as tools, uniforms and training.

Yes

If yes, who is your Jobactive Service Provider?

If yes, what is your Jobactive ID Number?

ELIGIBILITY TO WORK IN AUSTRALIA

* INSELEC Group is required under the Migration Act 1958 to ensure that any person applying for work is legally entitled to work within Australia

Yes

* Are you an Australia or New Zealand Citizen?

Yes

Birth CERT Registration Number

Full Name on Passport

Passport Number

Country of Issue

Type of Visa

EQUAL EMPLOYMENT OPPORTUNITY

Please select from this list any that apply to you. If you prefer not to answer please select the "prefer not to answer" option.

WORK PREFERENCES

Are you currently employed?

Yes

If YES please provide your notice period

* Current Position

Current Salary (Maps to JA Current Salary)

Frequency

Salary Expectation (Maps to JA Ideal Salary)

Frequency

Geographical Preferences

Preferred Work Type

Please select any of the locations in this list that you are also willing and able to work. This opens up more opportunities for yourself.

REFERENCE CHECK CONSENT

INSELEC Group would like permission to contact at least ONE of your referees provided during your interview prior to your details being forwarded to a client regarding your employment

* Do you consent to INSELEC Group contacting your referees for the sole purpose described above

Yes

WORK REFEREES

Reference 1

* Ref 1 - Name of Company

* Ref 1 - Name of Referee

* Ref 1 - Location

* Ref 1 - Contact Number

* Ref 1 - Referees Email

* Ref 1 - Referees Position/Title

* Ref 1 - Relationship to Referee

* Ref 1 - Your Position/Title

* Ref 1 - Start Date

* Ref 1 - Finish Date

* Ref 1 - Reason for Leaving

Reference 2

Ref 2 - Name of Company

Ref 2 - Name of Referee

Ref 2 - Location

Ref 2 - Contact Number

Ref 2 - Referees Email

Ref 2 - Referees Position/Title

Ref 2 - Relationship to Referee

Ref 2 - Your Position/Title

Ref 2 - Start Date

Ref 2 - Finish Date

Ref 2 - Reason for Leaving

EMPLOYEE PERSONAL DETAILS CONSENT

As part of our recruitment process, INSELEC GROUP collects information for the purpose of finding you suitable employment opportunities. Your information will be stored in a secure database within INSELEC GROUP. Your identity and personal details may be provided to prospective employers once a suitable position has been identified. You may request to gain access to this information at any time by calling INSELEC GROUP on (07) 3852 4252. For further details regarding your information and our Privacy Policy please refer to our Privacy Policy on our website www.inselec.com.au or ask our receptionist to view a copy.

INSELEC GROUP is a registered Employment Agent and/or complies with the Private Employment Agents (Code of Conduct) Regulation (QLD), Anti-Discrimination Act, Fair Trading Act, Freedom of Information Act, Industrial Relations Act, Privacy Act (Cwlth), Vocational Education, Training and Employment Act, Workers' Compensation and Rehabilitation Act, Workplace Health and Safety Act and Workplace Relations Act (Cwlth).

* Do you consent to your details being used as described above and detailed in our Privacy Policy

Yes

PHOTOGRAPHIC CONSENT

* Do you consent to having your photo taken and used for the purposes described above

Yes

EMPLOYEE DECLARATION

I hereby declare that the details provided by me during INSELEC GROUP's selection process are true and correct.

* Name

* Today's Date

HOW DID YOU HEAR ABOUT US?

* Pick from the following:

If Referral, please tell us who referred you

If Other, please provide details