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Monteath & Powys Services
Property Surveying
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Field Work Employment Application Form

Minimum conditions of employment for field work positions:
  1. Ability to read, write and speak well in the English language.
  2. Unencumbered issue of a NSW car drivers licence.
  3. Good physical condition, good eyesight and good hearing.
CONTACT INFORMATION
*Compulsory Fields.
Date
Title* Mr Mrs Ms Miss
Surname*
Given Names*
Street Address*
City*
State*  Postcode*
Country*
Phone* ( )
Mobile
Referral Phone ( )
Email*
Date of Birth (Optional)
Sex (Optional) Male Female
Are you an Australian Citizen or permanent resident?* Yes No
Do you hold a current (unencumbered / unlimited) NSW car drivers licence?* Yes No
Please provide details of your type of licence*
Other vehicle licence details
Do you have any pending proceedings which may remove your licence entitlement?* Yes No
Do you hold other relevant licences or certificates?
OH&S Green Card*:     Yes No
Senior First Aid Certificate*: Yes No
Other:
Other:
Please provide details of academic qualifications and / or relevant experience*:
Please provide employment history*
Date in Years Name of Employer Position Description
Eg. 2004 - Current IXL Surveyors Field Assistant  
-
-
Referees*  
Name Company Phone
Medical Declaration*  
To assist us comply with our obligation to ensure a safe workplace and in order to enable us to determine whether applicants are able to safely and adequately perform duties required by the position, please provide details of any previous or current injuries, illnesses or disabilities of which you are aware and which you believe may affect your ability to carry out the requirements of the position.
I am willing to undertake a medical examination and provide a medical certificate attesting to my current state of health.  
Yes No  
I understand that any false or misleading information given in this application, whether in writing or during an interview, may be reason for my employment, if I am appointed, to be terminated. I declare that to the best of my knowledge any information provided in or in relation to this application, is true, complete and correct.
Yes No
 
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