WARNING:

JavaScript is required to view this form. Please enable it in your browser settings.

Find out how

Employee Details Form

Personal Details

* First Name

* Last Name

Title

Pronouns

Date of Birth

* Mobile

* Email

Suburb

Postal Code

* State

Country

My Leave Registration #

Do you identify as Aboriginal or Torres Strait Islander?

Emergency Contact Details

1. Contact/Relationship

1. Contact Number

2. Contact/Relationship

2. Contact Number

National Police Check

Would you be willing to undergo a national police check as a condition of employment?

Australian Working Rights

Are you an Australian Resident / Citizen? Yes No

YOU MUST PROVIDE A COPY OF YOUR BIRTH CERTIFICATE OR PASSPORT TO PROGRESS YOUR APPLICATION. It is a Department of Immigration requirement that we ensure all employees are legally entitled to work in Australia before we can offer a position

Choose file

Nationality

Passport Number

Passport Expiry Date

Visa Number

Visa Expiry Date

Type of Visa

Banking Details

Account Name

Bank Details

BSB

Account Number

Superannuation Details

Superannuation Fund

Superannuation ABN

Superannuation USI

Member Number

Uniforms

PPE Shirt Size

Polo Shirt Size

PPE Pants Size

Business Shirt Size

Please note, by completing the Candidate Sign Off below, you are agreeing to being liable for any uniform costs if you do not remain with the business prior to completion of your probation period.

BHP WAIO SAP Number — Enter your BHP WAIO SAP number, if applicable.

Rio Tinto SAP Number — Enter your Rio Tinto SAP number, if applicable.

Tickets/Licenses/Certifications

Driver License

Choose file

Employee Sign Off

* The details provided here are true and correct at the time of onboarding. Please notify KeyWest Resources via written communication immediately should these change at any time during your employment with us.

Please answer the following questions regarding your current medical status and history:

Are you currently being treated by any doctor?

Have you ever tested positive to a drug or alcohol test?

Are you taking any medication?

Are you prepared to do a workplace drug and alcohol test?

Have you ever been hospitalised for an illness or operation?

Do you wear glasses for work?

Have you in the last 5 years had time off work for injury or illness?

If yes, do you have prescription safety glasses?

Have you ever had a work related injury or illness?

Is there any reason for you being unable to wear personal protective equipment?

Have you ever had a sporting injury?

Have you ever been refused life insurance, medical insurance, disability insurance, employment or military service?

Is there a family history of any medical conditions?

Have you ever been exposed to Asbestos

If you have answered YES to any of the above, please provide us further information

Do you do any of the following:

Do you engage in regular exercise?

What / How frequently?

Do you or have you ever smoked Cigarettes?

How many per day? What age did you start/quit

Do you or have you ever vaped?

How many puffs per day? What age did you start/quit

Do you drink alcohol?

How much per week?

Have you taken illicit drugs?

Details:

Do you have or have you ever had any of the following conditions:

Asthma / Bronchitis / Lung Problems?

Joint problems / fractures / arthritis / rheumatism?

Allergies or allergic to anything?

Kidney disease / bladder problems?

Back or neck problems?

Loss of hearing / Ear infections?

Blackouts / persistent headaches or migraines?

Malaria / Other tropical disease?

Cancer of tumour of any kind?

Mental illness or nervous troubles?

Deep Vein Thrombosis?

Palpitations / irregular heartbeat?

Depression?

Other joint injuries or conditions?

Eye Trouble?

Shortness of breath?

Fits or seizures?

Skin disorders / dermatitis?

Foot ankle or knee trouble?

Stomach problems / ulcers?

Head injury or concussion

Blood pressure / heart problems?

Hepatitis / jaundice / liver problems?

Suffered from heat stroke or heat exhaustion?

Hernia?

Tuberculosis?

Injury requiring an operation?

Any other medical or surgical conditions to be considered?

If you have answered YES to any of the above, please provide further information

Do you have any difficulty with any of the following activities:

Concentrating for any length of time?

Hearing a normal conversation?

Reading ordinary print?

Turning your head rapidly?

Bending or twisting?

Crouching or kneeling?

Repetitive movements of the arms, legs and / or head?

Understanding English (understanding safety directions

Gripping firmly with either or both hands?

Sitting / standing for two hours or more?

If you have answered YES to any of the above, please provide further information:

Update Candidate Record