Employee Application Form

Name *

First

Last

Email *

Phone *

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Date of Birth//

Are you an Australian resident?

Yes
No

Emergency Contact

Name

Relationship to you

Email

Phone

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Do you identify yourself as Aboriginal or of Torres Strait Island descent?

Yes
No

Have you ever worked in the Mining or Exploration Industry?

Yes
No

Position Area of Interest

ADMINISTRATION

ENGINEERING

EXPLORATION

Driller Exploration
Drillers Offsider
Field Assistant
Other

GEOLOGY

MINE MANAGEMENT

MAINTENANCE

MINERAL PROCESSING

MINING SURFACE

MINING UNDERGROUND

OCCUPATIONAL HEALTH AND SAFETY

SURVEYING

Have you had supervisory role?

Yes
No

Add Other Position You Are Seeking

HIGHEST EDUCATION / TRADE QUALIFICATION

What state did you complete your Education?

Where did you complete your qualification?

Education Completion Date

Do you have a current and valid Australian Drivers Licence?

Yes
License is not current
I don’t have a drivers licence

Expiry date

Upload license

Do You Have a First Aid Certificate?

Yes
No

Expiry date

Have you ever made a claim for Workers Compensation?

Yes 1 Claim
Yes 2 Claims
I have never claimed compensation for a work injury

A previous Workers’ Compensation claim is not a barrier to the consideration of an employment application. To assist in assessing opportunities for placement in appropriate employment, please complete this section accurately. The information provided in this section may be made available to an insurer in connection with any claim for workers compensation. A worker may not be eligible for compensation for an injury or disability sustained in the workplace where it is proved that the worker made willful and false representations as not having previously sustained the injury or disability at the time of seeking or entering employment. Therefore, your answers must be correct

Description of Injury(s) or Disability

Date Injury Occurred

Duration of Recovery

Employer

Do you have a disability, injury, illness or condition that may affect any aspect of your work performance or that may be aggravated or accelerated by the type of work you are applying for?

I have
I don’t have a disability, injury, illness or condition

A disability, illness, injury or condition is not a barrier to the consideration of an application for employment. To assist in assessing opportunities for placement in appropriate employment, please complete the following.

Please provide details of the disability, injury, illness or condition.

Are you currently taking any medications?

I take medications
No

Please provide brief details of the medications

Please inform us on prescribed or over the counter, not notifying us may slow your mobilisation due to drug and alcohol test processing,

Some of our clients we recruit for have an operator seat weight limit policy of 120 kg, will you be able to meet this requirement?

Have you ever had a criminal conviction?

Yes I have a criminal conviction
No

Description of Conviction/s

Can you provide a police clearance which is less than 12 months old?

Yes
No

AES has a Fitness for Work policy which includes a Drug and Alcohol Testing Program. Do you agree to participate in this Program and be randomly tested whenever required?

Yes
No

Fitness for Work policy

Do you agree to undergo a full pre-employment medical assessment (including a drug and alcohol screen)?

Yes
No

Do you agree to not be in possession of, under the influence of, or consume, intoxicating liquor or drugs?

Yes
No

Depending on the requirements of the work, some activities may be carried out at heights. Some medical conditions or other reasons may prevent you from working at heights. Are you able to work at heights?

Yes
No

Depending on the requirements of the work, some activities may be carried out in confined spaces. Some medical conditions or other reasons may prevent you from working in confined spaces. Are you able to work in confined spaces?

Yes
No

Have you returned from overseas or interstate in the last 14 days?

Yes overseas in the last 14 days
Yes interstate in the last 14 days
No

Have you been in contact with a confirmed or suspected case of Coronavirus in the last 14 days?

Yes I could be a close contact
No

Do you currently have any fever, cough, sore throat or shortness of breath?

Do you have a condition considered a risk on remote mine sites due to COVID-19?

AES NEEDS TO CHECK YOUR RIGHT TO WORK IN AUSTRALIA. Please upload your Passport or Birth Certificate or Citizenship Certificate.

Covid-19 Vaccination Status

Not Vaccinated with no intent to vaccinate
Not Vaccinated with intent to vaccinate
Commenced Vaccination – 1 dose completed
Commenced Vaccination – 2 doses completed
Booster completed

Comply with all AES and our Clients safety rules and procedures?

Yes
No

Wear and use the Project identification card(s) to enter and leave the site?

Yes
No

Comply with all security requirements including vehicle, baggage and personal searches?

Yes
I will NOT Comply with all security requirements

If you are a smoker, are you prepared to comply with all rules, which restrict smoking?

Yes or Non-Smoker
No

Wear and Use the correct personal protective equipment at all times

Yes
No

Do you agree to not carry or use any personal mobile phones unless authorised to do so?

Yes
No

Not carry or use any form of camera (including mobile phone cameras) unless authorised to do so?

Yes
No

Not use, carry, or be in possession of any weapons or firearms?

Yes
No

Agree to work shift work if required, subject to being medically fit to do so?

Yes
No

Agree to abide by Accommodation / Camp Conditions of Occupancy?

Yes
No

Agree that you may be charged or have deducted from your pay the cost of airfares if flights are missed.

Yes
No

Agree that you may be charged or will not be refunded medical costs if you don't start or complete your contract

Yes
No

Do you agree to all the Company Procedures and Policies

Yes
No

I understand and agree to the terms below: *

Yes
No

Before signing the declaration below, please read the following points and clarify anything that you are unsure of with this Company’s Recruitment Staff:

If I am considered suitable for an interview, I understand that the information I have provided and subsequent confirmation of my work history by AES may be provided to our Client/s or their authorised service provider, to verify my suitability for employment in the proposed position on the Client’s Project.

If I am offered and accept employment with AES, sensitive information about me such as medical details and results of drug and alcohol tests and pre-employment reference checks, as well as other information gathered during the course of my recruitment and employment including training & induction records, may be provided to our client/s before mobilisation to site. I understand the Company reserves the right to verify all information and any false statements will be sufficient to cause my rejection as an applicant, my dismissal if hired, or termination of my agreement or contract. I certify that the information set out above in this form to the best of my knowledge is true and accurate. I understand that the information may be held on a database and if I wish to, I understand that I have the right to access this information, if required. I can also request to correct, update or delete the information. Declaration: I understand that the information may also be used and disclosed by AES and our Clients to verify my suitability for employment for proposed positions in connection with other projects that may arise in the future and for managing matters in connection with my employment on other future projects. I understand that if I am offered and accept employment with AES, the information I have supplied may be provided to others during the course of my employment and used to manage matters relating to employment.

By Signing your full name you agree to the terms above