Please ensure this form is completed before returning your application for employment


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NamePlease ensure this form is completed before returning your application for employment
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Loy Yang B Power Station









LYP019-01 - APPLICATION FOR EMPLOYMENT FORM
Please ensure this form is completed before returning your application for employment.

Your application cannot be considered further if this form is incomplete.

For all enquiries please telephone (03) 5177 2068.











Position applied for:


















1. Personal Details




Given Names:




Surname:










Postal Address:






















Contact Details:

Home Ph:




Business Ph:













Mobile Ph:




Email:











Where did you see this position advertised?










(please specify)




The Latrobe Valley Express

The Age

Other Newspaper / Print Media:










University Website / Noticeboard

Internet Website:













Privacy




All personal, sensitive and/or health information collected by LYB, or by service providers engaged by LYB, is done so in accordance with the LYB Privacy Policy.

In the event that your application is unsuccessful, we will retain your application & resume on file for 12 months in order for you to be considered for any additional vacancies. Tick the box below if you do not wish to be considered for any additional vacancies:

Destroy my application at the conclusion of the hiring process






2. Education

PLEASE LIST ALL SECONDARY, POST-SECONDARY, TERTIARY & TRADE QUALIFICATIONS OBTAINED

(MOST RECENT FIRST)




Qualification




Years




School/Institution




Details (Majors, specialisations, etc)


























































































































































































































































3. Membership of Professional Associations

RELEVANT TO EMPLOYMENT

















































4. Employment History

PLEASE LIST YOUR LAST THREE POSITIONS, INLCUDING YOUR CURRENT POSITION
(MOST RECENT FIRST)





Last / Present Position:

Employer:










Address:










Position Held:




From:




To:










Reason for Leaving:










Key Duties & Responsibilities:












Employment History (Continued)

Previous Position:

Employer:










Address:










Position Held:




From:




To:










Reason for Leaving:










Key Duties & Responsibilities:







Previous Position:

Employer:










Address:










Position Held:




From:




To:










Reason for Leaving:










Key Duties & Responsibilities:













Periods of Unemployment:




Dates




Reason



































































5. Referees

Please complete details of people we may contact (without further notice to you)




Name




Position




Organisation




Business Address




Phone






























































































































6. Additional Questions







  • Do you have the legal right to work in Australia?


Proof of your legal right to work in Australia may be required on offer of employment.

Yes

No



















  • Do you have any convictions which are less than 10 years old
    and/or juvenile convictions which are less than 5 years old?


If yes, please give details:

There is no requirement to answer this question if the conviction/s have been quashed or have subsequently been pardoned.




Date




Court




Offence





















































































  • Fitness for work

Applicants are required to undergo a medical examination by the Company’s medical practitioners as part of LYB’s employment
process to ensure that they are able to safely perform the duties of the position applied for.

Having regard to the Position Description please indicate any pre-existing medical conditions, injury, past significant illnesses,
or other physical disabilities that may be affected by the work. This information will be provided to the Company’s medical practitioner prior to conducting any medical examination. Failing to notify or hiding a pre-existing injury or illness which might be affected by the nature of the proposed employment could result in that injury or illness being ineligible for future compensation claims.




Date




Nature of Injury




Employer (if applicable)




Claim settled or ongoing
















































































































  • Proof of Identity – Documents required as evidence of Identity

To validate your identity IPM Loy Yang B requires that you provide copies of at least one of the following identification cards containing your signature and your photograph:

    • Driver’s Licence

    • License to Perform High Risk Work (LHRW)

    • Passport

    • Proof of ID card (as issued for persons under the age of 18)










Identification Type




Number




Expiry Date
































































































Declaration & Consent

I hereby declare that:

  • The information provided in this form is true and complete, and I authorise LYB to contact the above referees and verify any information I have submitted herein;

  • I consent to the collection of personal, sensitive and/or health information reasonably required to assess my suitability for the position
    for which I have applied, by LYB and third party service providers collecting information on behalf of LYB; and

  • I authorise that any personal, sensitive and/or health information collected by third party service providers during the recruitment process, may be provided to LYB in order for LYB to assess my suitability for the position for which I have applied.




Name (print):




Date:













Signature:




















Please return this completed Application Form (together with your Resume and proof of ID) to:
Human Resources Group

Private & Confidential – Employment Application

ENGIE

Loy Yang B Power Station

Locked Bag 2500

Traralgon Vic 3844
Or via email to:

lybhr@au.engie.com



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