Position Date Title Mr  Mrs  Ms  Miss   First Name Last Name Address Postcode Suburb Email  Phone  Mobile Date of Birth Age Status Aus Citizen Resident Int Student Other Passport number Country of birth Visa number Expiry date Australian Drivers Licence yes no Own Car yes no         Do you have a medical condition or injuries that may impact on or restrict your duties yes no Details Any commitments that will stop you from working on rostered shifts yes no Details Are there any days you are not available or days that you prefer to have as RDO yes no Details   Are you prepared to work  Early Morning  Afternoon  Evening  Overnight  Any   ( Please tick preferred shifts )     If requested, would you have a medical/physical exam at a doctor nominated by Challenger yes no Do you give authority for Challenger to do a criminal record check if required yes no     What was your last place of employment Reason for leaving Position held & length of time Contact person for reference Phone         Other work experience Position held & length of time Reason for leaving Contact person for reference Phone         Challenger Cleaning and related companies policy is to pay fortnightly, no advance on pay or loans will be entered into, when leaving your position with the company pay will be held until confirmation is given that all keys / uniforms / equipment belonging to Challenger/related companies or the Clients have been returned.         I hereby declare the information I have provided to be true and accurate. I agree to work within the guidelines of Challenger related companies and Clients policies and procedures no yes