Employment Application Form

Important: this form must be completed in full (other than those sections designated as optional) in order for your application to be accepted.

1. THE POSITION APPLIED FOR:

Position No.:  ______	Classification/Level:   ____________________________
Section:  _______________________	Branch __________________________

2. YOUR PERSONAL DETAILS:

Mr	Mrs	Ms	Other:  _______________________
Surname:  _______________________		Given Names: _______________________
Postal Address:
_____________________________			Home Phone:
_________________ P/C ________			Work Phone:
Are you an Australian citizen?			Yes           No
If not, are you a permanent resident?			Yes           No
Are you employed in the Australian Public Service or a Commonwealth Government agency?			Yes - Permanent   Yes - Temporary   No
If 'YES' which department or agency?   _________________________
AGS No. ____________		Classification -	Nominal  _____________
			Actual  _____________
Have you received a redundancy / retrenchment benefit from the APS or a Commonwealth Government agency in the last 12 months?			Yes     No
If 'YES' date benefit effective ____ / ____ / ____

3. INFORMATION ON DESIGNATED GROUPS (this information is optional)

Are you female?		Yes / No
Are you an Aboriginal or Torres Strait Islander?		Yes / No
Are you from a non-English speaking background?		Yes / No
	Do you required an interpreter?	Yes / No
	Language	__________________
Are you a person with a disability?		Yes / No
	Do you required interview assistance?	Yes / No
	Describe	__________________