Casual Pilot Vessel Master A

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2. First name*
3. Last name*

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1. Street number*
2. Street*
3. Street type*Please choose... Alley Arcade Avenue Boulevard Bypass Circuit Close Corner Court Crescent Cul-de-sac Drive Esplanade Green Grove Highway Junction Lane Link Mews Parade Place Ridge Road Square Street Terrace
4. City, Town or Suburb*
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6. Country*Please choose... AFGHANISTAN ALBANIA ALGERIA AMERICAN SAMOA ANDORRA ANGOLA ANGUILLA ANTIGUA AND BARBUDA ARGENTINA ARMENIA ARUBA AUSTRALIA AUSTRIA AZERBAIJAN BAHAMAS BAHRAIN BANGLADESH BARBADOS BELARUS BELGIUM BELIZE BENIN BERMUDA BHUTAN BOLIVIA BOSNIA AND HERZEGOVINA BOTSWANA BRAZIL BRUNEI DARUSSALAM BULGARIA BURKINA FASO BURUNDI CAMBODIA CAMEROON CANADA CAPE VERDE CAYMAN ISLANDS CENTRAL AFRICAN REPUBLIC CHAD CHILE CHINA COLOMBIA COMOROS CONGO CONGO, THE DEMOCRATIC REPUBLIC OF THE COOK ISLANDS COSTA RICA COTE D'IVOIRE CROATIA CUBA CYPRUS CZECH REPUBLIC DENMARK DJIBOUTI DOMINICA DOMINICAN REPUBLIC ECUADOR EGYPT EL SALVADOR EQUATORIAL GUINEA ERITREA ESTONIA ETHIOPIA FALKLAND ISLANDS (MALVINAS) FAROE ISLANDS FIJI FINLAND FRANCE FRENCH GUIANA FRENCH POLYNESIA GABON GAMBIA GEORGIA GERMANY GHANA GIBRALTAR GREECE GREENLAND GRENADA GUADELOUPE GUAM GUATEMALA GUINEA GUINEA-BISSAU GUYANA HAITI HOLY SEE (VATICAN CITY STATE) HONDURAS HONG KONG HUNGARY ICELAND INDIA INDONESIA IRAN, ISLAMIC REPUBLIC OF IRAQ IRELAND ISRAEL ITALY JAMAICA JAPAN JORDAN KAZAKHSTAN KENYA KIRIBATI KOREA, DEMOCRATIC PEOPLE'S REPUBLIC OF KOREA, REPUBLIC OF KUWAIT KYRGYZSTAN LAO PEOPLE'S DEMOCRATIC REPUBLIC LATVIA LEBANON LESOTHO LIBERIA LIBYAN ARAB JAMAHIRIYA LIECHTENSTEIN LITHUANIA LUXEMBOURG MACAO MACEDONIA, THE FORMER YUGOSLAV REPUBLIC OF MADAGASCAR MALAWI MALAYSIA MALDIVES MALI MALTA MARSHALL ISLANDS MARTINIQUE MAURITANIA MAURITIUS MEXICO MICRONESIA, FEDERATED STATES OF MOLDOVA, REPUBLIC OF MONACO MONGOLIA MONTSERRAT MOROCCO MOZAMBIQUE MYANMAR NAMIBIA NAURU NEPAL NETHERLANDS NETHERLANDS ANTILLES NEW CALEDONIA NEW ZEALAND NICARAGUA NIGER NIGERIA NIUE NORFOLK ISLAND NORTHERN MARIANA ISLANDS NORWAY OMAN PAKISTAN PALAU PANAMA PAPUA NEW GUINEA PARAGUAY PERU PHILIPPINES PITCAIRN POLAND PORTUGAL PUERTO RICO QATAR REUNION ROMANIA RUSSIAN FEDERATION RWANDA SAINT HELENA SAINT KITTS AND NEVIS SAINT LUCIA SAINT PIERRE AND MIQUELON SAINT VINCENT AND THE GRENADINES SAMOA SAN MARINO SAO TOME AND PRINCIPE SAUDI ARABIA SENEGAL SEYCHELLES SIERRA LEONE SINGAPORE SLOVAKIA SLOVENIA SOLOMON ISLANDS SOMALIA SOUTH AFRICA SPAIN SRI LANKA SUDAN SURINAME SVALBARD AND JAN MAYEN SWAZILAND SWEDEN SWITZERLAND SYRIAN ARAB REPUBLIC TAIWAN, PROVINCE OF CHINA TAJIKISTAN TANZANIA, UNITED REPUBLIC OF THAILAND TOGO TOKELAU TONGA TRINIDAD AND TOBAGO TUNISIA TURKEY TURKMENISTAN TURKS AND CAICOS ISLANDS TUVALU UGANDA UKRAINE UNITED ARAB EMIRATES UNITED KINGDOM UNITED STATES URUGUAY UZBEKISTAN VANUATU VENEZUELA VIET NAM VIRGIN ISLANDS, BRITISH VIRGIN ISLANDS, U.S. WALLIS AND FUTUNA WESTERN SAHARA YEMEN ZAMBIA ZIMBABWE INTERNATIONAL OTHER Unknown
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1. It is our policy to provide employment opportunities for all people, including nominated Equal Employment Opportunity (EEO) target groups, on an equal and unbiased basis.
   
   In accordance with our EEO Management Plan, we are committed to diversity within our workplace and aim to generate employment of such. Candidates that identify in the following EEO target groups are encouraged to apply.
   
   GPC reserves the right to verify identification of the target groups. Documentary evidence will need to be provided to support the identification as an EEO target group and a GPC representative may contact you to discuss the documentary evidence requirements. A Confirmation of Heritage Statutory Declaration is able to be downloaded and submitted if required.*

   1. People with disability (including, physical, sensory, intellectual or learning, psychiatric)
   2. Aboriginal person
   3. Torres Strait Islander person
   4. Aboriginal and Torres Strait Islander person
   5. Australian South Sea Islander person
   6. People from a non-English-speaking background
   7. Women
   8. I do not identify with, or wish to identify with any of these groups
2. Do you have the legal right to live and work in Australia?
   
   GPC reserves the right to verify documentation. Documentary evidence will need to be provided to support your legal right to live and work in Australia and a GPC representative may contact you to discuss the documentary evidence requirements.*

   1. Yes, I am an Australian Citizen or Permanent Resident
   2. Yes, I hold an appropriate VISA (please provide a copy)
   3. No
3. Are you, or have you ever been employed by Gladstone Ports Corporation (GPC)?*

   1. Current Employee
   2. Previous Employee
   3. Never employed by GPC
4. Please outline any relevant qualifications you may hold (You will be required to submit copies of your qualifications as a part of your application).*
5. Do you hold a current Master <24m Near Coastal or Master Class V certificate?*

   1. Yes
   2. No
6. Do you hold a current Marine Engine Driver Grade 2 Near Coastal certificate?*

   1. Yes
   2. No
7. Do you hold a current Marine Radio Operators Certification?*

   1. Yes
   2. No
8. Please provide details of your skills and experience in relation to the following:
   KSC1- Experienced Master
   Description:
   • Understands and applies master mariner capabilities;
   • Displays skills necessary to conduct safe and efficient Pilot transfers;
   • Understands and manages risks, taking the necessary action to mitigate these when appropriate. *
9. Please provide details of your skills and experience in relation to the following:
   KSC2- Regulatory Framework
   Description:
   • Working knowledge of the NSCV code, in particular Part’s C and E;
   • Knowledge of TOMPA 1995 and TOMPR 2008;
   • Working knowledge of OH & S obligations. *