Employee Details Form

useful in recruitment procedures

1. Employee Details Form

Employee Details
Personal Details:
Name:
Employee Number:    -   
Are you known by
Another name:  No Yes
Address:
Post Code:
Postal Address:
Post Code:
Home Telephone:( )
Mobile:
Email: @
D.O.B: / /
Residency Details
Are you an Australian Permanent Resident?
 Yes No
If no, where is your country of birth?
Health
Do you suffer from an illness or disability which may effect your work?
 No  Yes
If yes, please describe, all information will be kept confidential

Are you on any prescribed medication that you think may affect carrying out your duties?
 No  Yes
If yes, please list the medication you are taking

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2. Bank Details Form

Please provide your banking details below for wages to be deposited to
Bank Details
Bank Institution:
Account Number:
B.SB Number: -
Account Name:
Bank Branch:
Nominated Deductions
Please tick if you wish to be part of Valley View Publishing Social Club, if you choose yes,
a weekly debit of $5.00 will be deducted from your wage
Valley View Publishing Social Club Yes No
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3. Emergency Details

Personal Details
Next of Kin:
Telephone (work):
Mobile:
Are you allergic to anything?
 No  Yes
If yes, please describe


Private Health Cover
 No  Yes
If yes, please list your membership(s)



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