Mobilize Labour Solutions

Registration Form

Please include as much information as possible in the form below.

Salutation

* First Name

* Last Name

Phone

* Mobile

* Email

* Address

* Suburb

* Postal Code

* State

* Date of Birth

* Nationality

Upload a copy of your Birth Certificate

Choose file

Passport Number

Upload a copy of your Passport

Choose file

* Are you an Australian permanent resident?

Upload a copy of your Australian Work Rights

Choose file

Emergency Contact Information

* Emergency Contact Name

* Emergency Contact Phone

* Emergency Contact Relationship

Other Information

Drivers Licence Number

* Do you have your own transport?

Do you have a Police Clearance?

* Do you identify as Aboriginal or Torres Strait Islander?

Job Details

Position Seeking

* Date Available

* Ideal Work Type

Salary / Wages Seeking

Frequency

Are you currently registered with a job network agency

Please upload relevant copies of licences, certificates & qualifications

Choose file

Medical Questionnaire

* Please select any conditions you have now or have had in your life

Have you travelled overseas in the past 28 days?

* Please detail any pre-existing / current medical, surgical conditions / injuries / claims
(if none, please state "none")

* Do you suffer from any back, neck, shoulder or knee complaints?
(If yes, please give details)

* Are you required take medication that may affect your work performance?
(if yes please give details of medications you are currently taking)

* Are you willing to undertake a medical examination?

* Are you willing to undertake a drug & alcohol test?

* Are you being treated by a doctor for any illness?
(if yes please give details)

* Have you ever been hospitalised for any injury or illness?
(If yes, please give details)

* Are you taking any medication for a medical condition?
(If yes, please give details)

* Have you had any operations?
(If yes, please give details)

* Have you had time off work due to injury or illness?
(if yes, please provide details)

* Do you wear glasses or contact lenses at work?

* Have you ever been refused life insurance, disability insurance, employment or military service due to injury or illness?
(if yes, please give details)

* Is there any reason why you cannot wear safety or protective equipment?
(If yes, please give details)

* Are you affected by heights or confined spaces?

* Do you have a problem with repetitive movements of hands or arms?
(if yes, please give details)

* Do you have any known allergies including medications?
(if yes, please give details)

* Have you been involved in a serious car accident?

* Have you had exposure to the following in your past jobs?

Please provide details

* Have you ever had a work related injury or illness?
(If yes, please give details)

* Have you had or are you currently making a claim for workers' compensation?
(if yes, please give details).

* I certify that the information provided on candidate registration and medical questionnaire is true to the best of my knowledge and I consent to Mobilize Labour Solutions collecting and providing this information to a third party in relation to securing either a temporary labour hire assignment or a permanent placement. I further acknowledge and accept that failure to declare information requested or relative to my application or employment now or in the future will result in me not being eligible for any claim for insurance resulting from workplace injury, and may also result in the termination of my employment without notice.

Mobilize Policies

Please read the policies linked here to accept the below.

* I have read, understand and agree with Mobilize's Pre-Employment Medical Policy

Yes

* I have read, understand and agree with Mobilize's Employee Industrial Relations Policy

Yes

* I have read, understand and agree with Mobilize's Anti-bribery & Corruption Policy

Yes

* I have read, understand and agree with Mobilize's Equal Opportunity Policy

Yes

* I have read, understand and agree with Mobilize's Health, Safety & Environmental Policy

Yes

* I have read, understand and agree with Mobilize's Injury Management Policy

Yes

* I have read, understand and agree with Mobilize's Personal Protective Equipment Policy

Yes

* I have read, understand and agree with Mobilize's Privacy Policy

Yes

* I have read, understand and agree with Mobilize's Alcohol & Drugs Policy

Yes