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Registration Form
General information
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Salutation
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Mr
Mrs
Ms
Doctor
Sir
Madam
Lady
Jedi Master
Duke
Lord
Her Majesty
Princess
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First Name
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Last Name
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Email
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Mobile
Phone
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Street address
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Suburb
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State
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Post Code
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Country
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Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji Islands
Finland
France
French Guiana
French Polynesia
French Southern territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See (Vatican City State)
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Ivory Coast
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libyan Arab Jamahiriya
Liechtenstein
Lithuania
Luxembourg
Macao
North Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia, Federated States of
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Ireland
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russian Federation
Rwanda
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Swaziland
Sweden
Switzerland
Syria
Tajikistan
Tanzania
Thailand
The Democratic Republic of Congo
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
United States Minor Outlying Islands
Uruguay
Uzbekistan
Vanuatu
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
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Seeking Work?
Yes
No
Maybe
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Preferred location
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Brisbane Southside
Brisbane Inner Northside
Brisbane Outer Northside
Brisbane Eastern Suburbs
Brisbane Western Suburbs
Northern Gold Coast
Southern Gold Coast
Logan and Beenleigh
Central Gold Coast
Sunshine Coast
Ipswich
Brisbane City
Toowoomba
Roma
Sydney
Mackay
Townsville
Cairns
Darwin
Perth
Regional Victoria
Melbourne
Adelaide
Tasmania
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Date of Birth
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Date Available
Select Date
Immediate
Select Notice Period
1 Week
2 Weeks
3 Weeks
4 Weeks
1 Month
2 Months
3 Months
4 Months
5 Months
6 Months
Current and Ideal Employment
Current
*
Current Employer
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Current Work Type
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Full Time
Contract or Temp
Part-time
Casual
Workcover
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Current Position
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Current Salary
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Frequency
Hour
Day
Week
Month
Year
Ideal
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Ideal Salary (numbers only)
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Frequency
Hour
Day
Week
Month
Year
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Ideal Work Type
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Full Time
Contract or Temp
Part-time
Casual
Workcover
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Ideal Position
Additional Information
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Next of Kin - Name
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Next of Kin - Contact number
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Australian citizen?
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Yes
No
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Indigenous and Torres Strait Islander descent?
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Yes
No
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Valid driving licence?
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YES
NO
SUSPENDED
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Any work restrictions?
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No
Medical
Visa
Personal
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Criminal Offence charges within Australia?
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Yes - Awaiting Conviction
Yes
Yes - Spent
No
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Criminal Offence charges Overseas?
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Yes - Awaiting Conviction
Yes
Yes - Spent
No
References
Referee 1
Ref 1 Name
Ref 1 Company
Ref 1 Phone Number
Ref 1 Email Address
Referee 2
Ref 2 Name
Ref 2 Company
Ref 2 Phone Number
Ref 2 Email Address
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