Synergen Power Pty Ltd /
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Synergen Power Pty Ltd /

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.

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 Advertiser / The Age / Other Newspaper / Print Media:
SEEK / Internet Website:
Privacy
All personal, sensitive and/or health information collected by ENGIE South Australia, or by service providers engaged by ENGIE South Australia, is done so in accordance with the ENGIE South AustraliaPrivacy 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 ENGIE South Australia employmentprocess 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 ENGIE South Australia 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 ENGIE South Australia 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 ENGIE South Australiaand third party service providers collecting information on behalf of ENGIE South Australia; 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 ENGIE South Australia in order for ENGIE South Australia 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) to:

Pelican Point Power Ltd

PO Box 1276

North Haven SA 5018

Or email

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