Please let us know if you have any of the following conditions: Heart condition / High Blood pressure / Breathing or lung condition / joint problems / chest pains / asthma, bronchitis / Dizzy spells, fits, faints or black outs / Head injury or loss of consciousness / Hernia or rupture / Anxiety or depression
Please let us know your Job Service Provider. (The company engaged to help you source work for example Max Employment / Mission Australia etc)
Company Name / Branch / Contact Person
Please let us know if you have any of the following issues: Back or neck condition/problems / Knee, foot or ankle condition / Shoulder condition / Wrist or elbow condition / Broken bones or dislocations
Do you have any current health problems not mentioned? Have you ever had a work related injury? Have you had surgery in the past 5 years? Please list your responses below
PLH takes every effort to ensure you are safe at work. Before starting with any PLH client you are required to complete our general safety induction. By signing this statement, you agree that PLH has provided you with the general safety induction relevant to your industry and you are well informed with general site safety. The induction incorporates our OHS Handbook, safe operating procedures for basic power tools, our Health & Safety policy, Civil Construction safety procedures for Manual Handling & Container Unloading and safe operating procedures for forklifts. By signing this document, you agree that PLH has made every attempt to ensure your safety at work and has provided you with a comprehensive general induction. You also agree the information provided is true & correct & will be used by PLH in all aspects regarding your employment.
I hereby certify the PLH can collect, disclose & store my information in line with the privacy & collection statement.
I authorise where necessary for PLH to conduct a security clearance or probity check as required by their clients.
I authorise for PLH to reformat (where necessary), copy or print my resume for their records and for the purposes of forwarding to perspective employers.
I authorise for PLH to approach my given referees to obtain relevant information in regard to my previous work history.