Seasonal Registration Form

Personal Details

Candidate Name:			Jobseeker ID#:
Postal Address:			Date of Birth:
Home Phone No:			Mobile Phone No:

Applicants Status:

Check Appropriate

Registered with recruitment agency
Registered with Job Network Agency
Name of Agency
Enrolled as a student
Currently working more than 15 hrs p/week
In receipt of Centrelink Benefit
Not an Australian Citizen, Requiring a permit to work
Home maker/Seasonal Worker
Other

Seasonal Work Requirements and Experience

What industry are you seeking seasonal work in?

Fruit Harvest
Aquaculture
Hospitality/Tourism
Relevent Experience

Transport

Does the Applicant -

Have a current driver's licence
Have access to a car
Have no transport
Rely on Public Transport

Worker availability and preferred locality

Worker Availability		Preferred work location
December 2003		Lower Huon
January 2004		Upper Huon/Channel
February 2004		Derwent Valley
March 2004		Coal River Valley
April 2004		Tasman Peninsula
May 2004
June 2004

Accommodation

Does the Applicant

Need Accommodation
Plan to Camp
Not require Accommodation
Have Accommodations Arranged

Information Agreement and Privacy Disclaimer

All personal information on this form is protected. The information is collected for the purpose of helping you get a job. It is also used for administration purposes, including contacting future employers for verification of employment and will be handled confidentially, in accordance with the Privacy Act of 1988. Information on this form may also be disclosed to Centrelink and/or DEWR for administrative, evaluation and monitoring purposes.

I authorize countrySKILLS to use the personal information supplied by me for the following purposes:

• To access records through the Integrated Employment System (IES)
• To present to prospective employers on my behalf
• For internal use (e.g. administration of services, for identification)

I understand that this material will not be used for any purposes other than to assist my employment prospects.

I Understand

Submit Application