EmailMe Form - NQEI Pty Ltd - Register your Interest

Name

First Last

Email

Landline Number

Mobile Number *

Address

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

Please select your field of work *

Other field of work not listed above

eg. Apprentice Electrician

Current drivers licence you hold?

Nationally recognized training licences, tickets & certificates *

List any you currently hold.

How many years experience do you have in your field of work?

1-2

2-4

4-6

6+

Please list work history with a brief description of the type of work, and business.

eg.
1. Downer - E/I Technician, 2013-15, Wheatstone construction project, WA
2. UGL - Fitter & Turner, 2015 (6 week shutdowns x 4), Stanwell Powerstations, QLD
3. etc.

Have you ever been involved in a work place incident regarding a OH&S matter *

Yes (complete statement below)

No

Complete a statement of the incident

Do you (or have you) suffered from any medical conditions listed below? *

Other medical condition detail

Reference

Are you a smoker? *

Yes

No

Whose responsibility is it to wear the correct PPE to perform job tasks? *

You as an individual

Or the company

Have you completed a first aid course in the past 12 months? *

Yes

No