In the Interest of Improving Our Recruitment Service, Your Response to the Following Question

APPLICATION FOR ADVERTISED VACANCY

Position applied for: / Click here to enter text. /
Surname: / Click here to enter text. / Given Name: / Click here to enter text. /
Address: / Click here to enter text. / Postcode / Click here to enter text. /
Telephone Contact Number: / Click here to enter text. / (During Office Hours) / Click here to enter text. / (Private)
Email: / Click here to enter text. /
Please Tick
Are you Australian or do you have Permanent Resident Status? / YES / ☐ / NO / ☐ /
If NO, do you have a current Work Visa? / YES / ☐ / NO / ☐ /
Do you have a current valid Driver’s Licence? / YES / ☐ / NO / ☐ /
If Yes, / Licence No: / Click here to enter text. / Expiry Date: / Click here to enter a date. / Classes: / Click here to enter text. /
I have attached a photocopy of my current
Driver’s Licence / YES / ☐ / NO / ☐ /
Police Clearance relevant to the job applied for* / YES / ☐ / NO / ☐ /
Working with Children check* / YES / ☐ / NO / ☐ /
* Only required if you are successful and they are listed in the selection criteria – DO NOT apply for these checks when applying for a position
LSL Transfer*
Will you be seeking LSL transfer* / YES / ☐ / NO / ☐ /
*This only applies to employees working for Local Government in the NT
If you are seeking LSL transfer, you are required to provide to the Council, not later than 28days after the requirement, a written declaration stating whether you were employed by another Local Government organisation in the Northern Territory within the 3months immediately preceding the entering into employment with the Regional Council. You will also be expected to state whether you elect to transfer accrued and accruing rights to long service leave to the later employment (with CDRC).

In the interest of improving our recruitment service, your response to the following question would be appreciated.

How did you learn of this vacancy?
☐ / Centralian Advocate / ☐ / Govjobs.com / ☐ / seek.com
☐ / NT News / ☐ / LGJobs.com
☐ / Other (please specify) / Click here to enter text. / ☐ / LGassist.com
HEALTH
To the best of your knowledge and belief are you of sound health? / YES / ☐ / NO / ☐ /
If No, please provide brief details:
Click here to enter text. /
Click here to enter text. /
Applicants who have a health condition are welcome to discuss its relevance to the position applied for by contacting Human Resource Advisor on (08) 8958 9547.
Please Note: It is the Central Desert Regional Council policy that applicants may be required to attend a pre-employment medical.
A health condition is not an automatic barrier to employment with the Central Desert Regional Council.
CONVICTIONS
Do you have any current convictions for any offence from any court; or are you currently the subject of any charge pending before any court? / YES / ☐ / NO / ☐ /
If yes, please give details
Click here to enter text. /
Please Note: Possessing a criminal record does not necessarily make an applicant ineligible to be considered for a position at the Central Desert Regional Council. Any position that is carrying out “child-related work” must have a Working with Children check.
RECRUITMENT POOL
If this position is listed for pool recruitment do you wish to be considered for similar vacancies which may arise in the next 12 months? / YES / ☐ / NO / ☐ /
DECLARATION
I declare the above statements to be true in all aspects. I acknowledge that any statement, which is found to be false or deliberately misleading, will make me, if employed, liable for dismissal
Click here to enter text. / Click here to enter a date. /
Signature / Date

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