Staff Application

Step 1 of 6

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Contact Details

Date of Application

DD dash MM dash YYYY

Title

Name

First Name Surname

DOB

DD dash MM dash YYYY

Email Address

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Mobile Number

Work/Home Number

ELIGIBILITY

Are you over 18 yrs?

Yes

Are you a permanent resident or citizen of Australia?

Yes

If not a resident or citizen are you legally permitted to work in Australia?

Yes

If you are on an Australian visa, indicate Type

If you are on an Australian visa, indicate Number

If you are on an Australian visa, please provide your passport number:

Do you speak any other languages?

Yes

What Languages

AVAILABILITY FOR WORK

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Employee Status

Full Time

Part Time

Casual

Licenses and Certificates obtained

Responsible Service of Alcohol Certificate

Responsible Conduct of Gaming Certificate

Advanced Responsible Conduct of Gaming Certificate

NSW First Aid Certificate

Other Certificates

REFEREES

Please note: By giving the names and contact numbers of these referees you are giving consent for Club Willoughby to contact them.

Work Title

Contact Number

Work Title

Contact Number

PERSONAL HISTORY

Have you been convicted of a criminal offence within the past 5 years?

Yes

Have you ever been convicted of an offence relating to theft, dishonesty or gaming?

Yes

If you answered “YES” to any of the above questions, please provide further details below:

PERSON TO NOTIFY IN CASE OF ACCIDENT OR ILLNESS

Name

Contact

Relationship

PROBATION

I understand and accept that as a condition precedent to my obtaining the position applied for, I shall have to undergo a probationary period of 6 (six) months. At the end of this period the Club may, at its sole discretion, confirm or annul the appointment.

DECLARATION

I further declare that the statements made by me in this application are true, complete and correct. I understand that a false or misleading answer to any question in this application will be regarded as misconduct and will be grounds for my dismissal from employment. I also understand that as a hospitality venue I am expected to work: early mornings, nights, public holidays and weekends as required.

I, the undersigned, confirm that I have attached relevant certificates and a copy of my Resume.

Signature

Name

Date

DD dash MM dash YYYY

RESUME

Max. file size: 50 MB.

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