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| Surname: |
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Given Names: |
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| Street: |
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Suburb: |
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| Postcode: |
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Phone No: |
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| Mobile No: |
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Country of Birth: |
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| LICENCES & FIRST AID |
| Security Licence #: |
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Expiry Date: |
Category: |
| First Aid Cert #: |
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Expiry Date: |
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| Drivers Licence #: |
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Expiry Date: |
Category: |
| Firearms Licence #: |
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Expiry Date: |
Category: |
| How long have you been involved in the security industry?
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| How long have you held the Security Licence for? |
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| List any security qualifications you may hold: |
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| List any security experience you may have: |
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| Have you ever been refused a Security Licence? |
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| TRANSPORT |
| Method of Transport (i.e. Public, Car, Bike, Other): |
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| Number of years driving: |
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| Have you ever been involved in a motor vehicle accident?
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| If so, how many? |
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| Details of accident(s): |
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| Were you driving a company vehicle at the time? |
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| CONVICTIONS |
| Have you ever been convicted of a motor vehicle offence
including traffic infringement? |
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| Details of offence(s): |
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| Have you ever been convicted or charged with any offence
other than a traffic offence? |
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| Are there any criminal proceedings pending against you in
any Court in Australia? |
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| Have you ever had your Financial Affairs administered under
bankruptcy in any state of Australia? |
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| How long have you lived in Sydney? |
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| SHIFT PREFRENCES |
| Have you ever worked shift work (Yes or No)? |
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| Which shifts do you prefer (i.e. Day, Afternoon,
Night, Any? |
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| Have you ever worked 12 hour shifts before (yes or No)? |
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| How much notice would you require to attend the shift? |
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| CURRENT EMPLOYER DETAILS (if any) |
| Are you currently employed (Yes or No)? |
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| If Yes, please provide details: |
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| Are you currently employed in operating your own business
(Yes or No)? |
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| If so, please specify the nature of the business: |
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| MEDICAL |
| Do you have any medical disabilities (Yes or No)? |
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| If yes, details: |
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| Have you ever suffered a work related injury (Yes or No)?
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| If yes, details: |
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| Have you ever claimed Workers Compensation (Yes or No)?
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| SHORT ANSWERS |
| Please list any qualifications you may feel are relevant to
this application: |
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| REFERENCES |
| Name: |
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Contact No: |
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| Name: |
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Contact No: |
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| WARRANTY |
The information I have provided on this form is true and
correct to the best of my knowledge. I provide my express permission for JEES
Administration to conduct any enquires to support the information I have supplied in
this application.
* By entering your name and email address here, you are
stating that you agree to the terms of your Warranty stated above. |
| Please enter your name: |
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E-mail Address: |
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| Date:
Day
Month
Year |
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