[DCC- Casual Contractor Salary] Application Form Step 1 of 3 33% Name* First Middle Last Date of Birth* MM slash DD slash YYYY Mobile*Email* Address* Address Address Line 2 Suburb State Poscode Emergency Contact Name* First Middle Last Emergency Contact Mobile*Emergency Contact Email* Emergency Contact Relationship* Residency Status*SelectPermanent ResidentForeign ResidentSkill MigrationWorking Holiday MakerStudent VisaTemporary VisaNo VisaThis is a legal choiceVisa Number If you are not a Citizen, we would require your Visa Number.ExperiencesWork experience with HVAC ?* Yes No Other work experience* Carpentry Mechanic Labourer Electrician Plastering Construction Plumbing Road works Stone Mason Painter Cleaner Handy Work At Home Others Experience towing a trailer with a car?* Yes No InsuranceInsurance Name* Policy Number* Works Safe Policy* Workcover Insurance https://www.worksafe.vic.gov.au/getting-started-workcover-insuranceInsurance - Business Policy https://www.bizcover.com.au/business-insurance/?msclkid=2dd080dca2221b089065e4b6a3366206&utm_source=bing&utm_medium=cpc&utm_campaign=2.0.1%20Public%20Liability%20Insurance%20Oct%20-2017&utm_term=insurance%20public%20liability&utm_content=Oct2017-2.0.1%20Public%20Liability%20InsurancePayment InfoPay into ABNABN Number, ABN* https://business.gov.au/registrations/register-for-an-australian-business-number-abnBank Name* eg Commonwealth BankBank Account Name* eg James BondBank Account Number* Bank BSB Number* CarDo you in the last 5 years have you or any other person who regularly drive the insured vehicle/trailer.1. Been convicted of or have any fines or penalties imposed for any driving related alcohol or drug offences or charges pending for such offences?* Yes No 2. Has a driver licence been cancelled or suspended or restricted or been disqualified from holding a drivers licence for any period in the last 5 years?* Yes No 3. Has any motor vehicle refused in the last 5 years?* Yes No 4. Had a motor claim in the last 3 years?* Yes No 5. Below the age of 25 years old? If yes, let us know, we have to increase insurance coverage for trailer.* Yes No Car Rego Number* The car that would used to predominantly tow the trailerCar Insurance Policy & Expiry* Terms & ConditionsI agree that all the information and documents uploaded into google drive [email protected] are 100% true and accurate.*
