Employee Induction – Pre Register

Step 1 of 6

16%

First Name*

Last Name*

Address*

Street Address City State Postcode Country

Email*

Phone*

Mobile*

Date Of Birth*

DD slash MM slash YYYY

Next of Kin (relationship)*

Their Phone*

Qualifications

Driver's License

Driver's Licence Number

Expiry Date

DD slash MM slash YYYY

Trade Licence

Trade Licence Number

Expiry Date

DD slash MM slash YYYY

Construction Induction

Construction Induction Number

Expiry Date

DD slash MM slash YYYY

State of Issue

Superannuation Fund

Superannuation Fund Name and Number

Expiry Date

DD slash MM slash YYYY

Coinvest

Coinvest Number

Expiry Date*

DD slash MM slash YYYY

Severence Scheme

Severence Scheme Number

Expiry Date

DD slash MM slash YYYY

Are you legally entitled to work in Australia?*

Yes

Previous Experience

Employer / Nature of Business

Employed from*

DD slash MM slash YYYY

Employed until

DD slash MM slash YYYY

Position held

Referee name and phone number

Attach your CV

Accepted file types: pdf, doc, txt, docx, jpg, jpeg, Max. file size: 8 MB.

Brief description of profile

Attach copies of your licences

Accepted file types: pdf, jpg, jpeg, Max. file size: 8 MB.

Attach copies of your licences

Accepted file types: pdf, jpg, jpeg, Max. file size: 8 MB.

Attach copies of your licences

Accepted file types: pdf, jpg, jpeg, Max. file size: 8 MB.

Attach copies of your licences

Accepted file types: pdf, jpg, jpeg, Max. file size: 8 MB.

Suitability of Work

As stated in our Health & Safety Policy our aim is to promote our business in a way that protects the safety of employees, contractors, customers and the public. To assist us in achieving our stated objectives we need to be made aware of any pre-existing injury or condition that could be exacerbated by the activities that you may be engaged in. Failure to disclose details relating to any pre-existing condition could lead to a claim for compensation being rejected by our insurer in the event of the recurrence, aggravation, acceleration or deterioration of your pre-existing condition.

The dynamic nature of electrical contracting places our employees in many and varied working environments and whilst our activities are controlled by either or all SWMs, JSEAs and Take 5s a basic understanding of our individual employee’s physical capabilities and or limitations is essential to ensure that no individual is placed into a situation that could be detrimental to their wellbeing.

To furnish us with an appreciation of those work environments that best suit your current capabilities / situation please indicate which of the following scenarios you feel that you are suitable for.

Workshop or panel wiring or bench work, involving long periods of standing?*

Yes

Any type of activity involving bending, kneeling or working at ground level?*

Yes

Any type of lifting in including assisting in two man lifts?*

Yes

Unrestricted mobility / movement of limbs, fingers, etc.?*

Yes

Working outdoors, quite possibly for the full day?*

Yes

Dusty, dirty or fume-laden environments requiring the use of dust masks or face and canister filter masks?*

Yes

Wearing of appropriate gloves for nearly all work activities?*

Yes

Working at heights employing appropriate aids, EWP, scaffold, etc?*

Yes

Working extended shifts / overtime possibly at short notice?*

Yes

Attending call-outs if required, definitely at short notice?*

Yes

Participating in an after-hours call roster?*

Yes

Work shift work?*

Yes

Work at distant localities beyond the office 50k radius?*

Yes

Work at distant localities requiring living away from home?*

Yes

Working at non-smoking sites where smoke breaks can only be taken during scheduled meal breaks?*

Yes

Carrying out long session of visually detailed work (e.g. reading technical instruction and/or electrical circuits and diagrams)?*

Yes

Suitability of Work

GMK is committed to the safety and well being of employees, please advise the following so we may ensure correct support in case of an emergency.

Any medical conditions that may require GMK intervention (e.g. anaphylaxis, insulin, epilepsy)?*

Yes

Prescription drugs which might require GMK support in administering in an emergency?*

Yes

Hearing test undertaken within the last 12 months?*

Yes

Please comment below of any additional information that we at GMK should be aware of.

Please note: if you have answered 'yes' to questions 1 or 2 above, please ensure your Manager and key supervisors are aware of what is required to assist you.

I furnish the above information, sincerely believing it to be true and correct and acknowledge that my employment may be terminated by the provision of false information provided on this form.*

Yes

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Employee induction - pre register

General Induction – Part 1