Personal Details

* Indicates required field

Name *

First

Last

Gender *

Male Female

Email *

Phone Number *

Date of Birth *

Country of Origin *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Passport Number if non Australian Resident *

Australian Tax File Number *

Payment Options! Direct Payment to Bank account *

I wish to have my weekly pay placed direct into my bank account - Details below:- (This will take place weekly on Monday Nights)

Account Name *

Bank Name: *

Cheque *

I wish for a cheque to be written out each week for collection on Tuesday:-

BSB Number: *

Account Number: *

Pay Slip Emailed *

I wish for my Pay Slip to be emailed to me on a weekly basis

Email Address: *

Pay Slip to be Collected from Office *

I wish for my Pay Slip to be a hard copy and available for collection at the office on Tuesday:

SUPERANNUATION CHOICE FUND *

I wish for my Superannuation payment to be made into the following superannuation Fund.

No Superannuation Fund *

I do NOT have a Superannuation Fund, please make payment into Valonuma Pty Ltd primary Fund Prime Super

Superannuation Fund Name: *

Superannuation Fund Member Number: *

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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