Job Position
Title
Surname
Given Name
Address
Suburb
Postcode
State
TAS
NSW
VIC
SA
QLD
WA
NT
ACT
E-mail Address
Contact Phone Number
Health
I have a medical condition that may preclude me from undertaking the duties of the position I have applied for?
I have a disability or injury likely to affect my work performance?
I have made a Workers` Compensation claim?
If ` YES` please provide details.
Criminal Record
I have current/pending convictions for any offences from any court.
If ` YES` please provide details.
Watkins is an Equal Opportunity Employer, are
you:
Male
Female
Disability
Aboriginal or Torres Strait Islander
Non English speaking background
Qualifications/Experience
I declare that the above statements are true in
all respects.
I AGREE
I DISAGREE