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Drivers Villacare
Pty Ltd Workshop Lexaid Pty Ltd M/mnt & Admin. Bunker Freight
Lines Pty Ltd
Please note: It is not
compulsory for the applicant to complete every one of the details sought in
this form. All details provided by the applicant on this form are provided
voluntarily and the applicant agrees that he/she has not been induced or
offered any incentive by any person to supply any of the details provided. We
are an equal opportunity employer. It is our policy to abide by all Federal,
State and Local laws concerning discrimination. No question is intended to
elicit information in violation of any such law, nor will any information be
used contrary to this.
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| What is
your general health condition? |
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| Do you have
any pre-existing or on-going injuries, health or physical or psychological
conditions or, ailments including neck muscular strain, hernia, sight or
hearing deficiencies OR have you previously suffered from any of these?
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| If yes,
please provide details |
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| Have you
ever claimed Compensation?
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| If yes,
give details: (Date, Type of injury, employer, period of disablement, was lump
sum paid etc.)
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