Application Form
(All fields are required)
1. Advertising Avenue:
Where did you see this position advertised?
2. Eligibility:
Do you have the legal right to work in Australia?
3. Residency:
Which of the following best describes your current residency?
4. Area of Interest:
What area of DIALOG Fitzroy are you interested in working in?
5. Area of work:
If you selected other in the previous question, please detail which other aspect of the business you would like to be involved in:
6. Licenses':
Please indicate if you hold any of the following licenses
7. Certificates:
Please indicate if you hold any of the following certificates
8. Motivational Fit:
Please outline any relevant experience/qualifications you have for this position.
9. Work Availability:
Please select the option that best fits your availability
10. Location:
Which DIALOG Fitzroy location are you interested in working from?
11. Former DIALOG Fitzroy Australia Employee:
Have you been previously employed by DIALOG Fitzroy Australia Ltd or by any other DIALOG company in Australia or overseas?
12. Drivers Licence:
Please indicate all classes of full Australian Drivers Licence that you hold.
13. Medical :
Do you, or have you ever suffered from any medical, mental or physical condition that may affect you ability to perform the functions or responsibilities of the position you are applying for?
14. Medical:
If yes to the above question please provide details below. If no please write N/A.
15. Criminal Convictions:
Have you ever been convicted of a criminal offence that would affect your ability to do this role?
16. Criminal:
Do you have or are you waiting for criminal charges to go before the court?
17. Declaration - Documentation:
I accept that prior to the commencement of employment I will be required to supply the original documents pertaining to stated qualifications/certificates for DIALOG Fitzroy Australia Ltd to certify, a current driver licence, passport or a birth certificate and a copy of a current Australian work permit, if applicable.
18. Declaration :
I declare that to the best of my knowledge the information I have provided on this form is true and correct. I understand that if any false information has been given or any material fact is withheld, I will not be accepted for employment, or if I am employed, I will be dismissed. I understand that any personal information provided will be used according to the Australian Privacy Act and may be held for up to 12 months.
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