Employment Application Form

Valonuma Pty Ltd

Employment Application Form

* Indicates required field

Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Email *

Country of Origin *

Phone Number *

Date of Birth *

Driver's Licence *

Visa Status: (Please provide PASSPORT number) *

Australian Tax File Number *

Gender *

Male Female

Do you speak English fluently *

Do you have your own Transportation? *

Are you available to work weekends? *

Emergency Contact Information *

First

Last

Relationship (Mother/Father, Travel Partner) *

Phone Number *

Are you travelling with other people, please provide details, (eg. Name(s), will they also be applying for a position with Valley Fresh, if so they too must complete an application form)?. *

Tyre of Employment applying for: *

Picking Position Packing Position

Employment History (Please provide details of most recent employment) *

First

Last

Job Description *

Date of Employment: *

Company / Business Name *

Reason for Leaving *

Have you worked within Horticulture/fruit industry previously? If so Please provide details:- *

Qualifications, Skills & Abilities (Please provide any qualifications, skills or abilites that you may bring to the positions - for example: forklift licence, safe food handling certificate, first aid) *

Health: (Do you have any health or medical conditions that may affect your safety or duties during employment? For example, Heart problems, blood pressure, back pain, asthmas, muscles problems other) If so please provide a description of the condition and how it can be managed during your employment *

Accommodation Details: Do you require on farm accommodation arrangements? *

DECLARATION *

By ticking this box, I declare the information I have provided in this application is true and correct and I understand by providing misleading particulars may affect my employment status.

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Valonuma Pty Ltd Employment Application Form

Valonuma Pty Ltd

Employment Application Form