Inverell Shire Council is collecting personal information from you as part of the recruitment and selection process. Inverell Shire Council recognises the importance of privacy and is committed to ensuring the privacy of your personal information collected and/or received by us.

1. Yes I agree to the privacy statement*

1. Title* Mr Mrs Ms Miss Dr Other
2. First name*
3. Last name*

1. E-mail*
2. Phone*

   Digits only or add + for international numbers

1. Street*
2. Street Cont.
3. City, Town or Suburb*
4. Postcode or Zipcode*
5. 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 HONG KONG SAR, CHINA 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 MACAU SAR, CHINA 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
6. State, Region or Province*Please choose...

1. LinkedIn URL

   (Please click on your profile and copy the URL from your profile page.)

1. By submitting this application:*

   1. I am in agreement for Council to contact the nominated referees or any other person quoted in my application for employment screening checks to be conducted upon me;
   2. I have read and understood the Position Profile and accept the conditions contained in it. I believe the conditions set out in the Position Profile to be fair and reasonable;
   3. I declare that the information provided in support of my application is true and that the qualifications that are asserted in my application are genuine; and
   4. I acknowledge that any employment or offer of employment may be withdrawn if I have provided false information in support of my application including falsely claimed qualifications.
2. Are you legally allowed to work in Australia?*

   1. Yes - Permanent resident or citizen.
   2. Yes - Valid work visa.
   3. No
3. Are you currently an active client of an employment agency? If so, please detail which one below.*
4. What class of drivers licence do you currently hold?*

   1. NSW Class C
   2. NSW Class LR
   3. NSW Class MR
   4. NSW Class HR
   5. NSW Class HC
   6. NSW Class MC
   7. Other class of licence/No licence.
5. Please details your education history as it relates to this role, including any certifications, degrees or any other relevant history.*
6. Please briefly summarise your experience as it relates to this role.*
7. Do you hold any of the following?

   1. Enter and work in confined spaces unit of competency.
   2. Work safely at heights unit of competency.
   3. SafeWork NSW General Construction Induction card ('White Card').
   4. SafeWork NSW Traffic Control Work Traffic Controller (TCR) accreditation.
   5. SafeWork NSW Traffic Control Work Implement Traffic Control Plans (IMP) accreditation.
   6. IXOM Liquefied Chlorine Gas Emergency Preparedness accreditation
8. It is a condition of employment in this role that you participate in an on-call roster on a rotating basis, do you understand this condition and agree to participate?*

   1. Yes
   2. No
9. This condition has been determined to be at-risk of exposure to Hepatitis A and Hepatitis B, and it is a condition of employment that the successful candidate is able and willing to obtain vaccinations against these illnesses at Council's cost. Do you understand and agree to this condition?*

   1. Yes
   2. No
10. REFEREES - Applicants must supply details of at least two (2) current referees.
    
    Name of referee 1:*
11. Company name:*
12. Position title:*
13. Relationship to referee: (e.g. supervisor)*
14. Contact telephone number(s): *
15. E-mail address:*
16. You must advise your referee about your application and give them permission to provide a verbal reference. Have you contacted your referee?*

    1. Yes
    2. No
17. Name of referee 2:*
18. Company name:*
19. Position title:*
20. Relationship to referee: (e.g. supervisor)*
21. Contact telephone number(s):*
22. E-mail address:*
23. You must advise your referee about your application and give them permission to provide a verbal reference. Have you contacted your referee?*

    1. Yes
    2. No

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