Job Application Reference Number, if applying for a vacancy position.
1. General Details
Name*
First Last
Gender*
- Male
- Female
Date of Birth*
Home Address*
Street Address Address Line 2 Suburb Post Code
Home Phone*
Mobile*
Email*
2. Emergency Contact
Name*
First Last
Phone*
Address*
Street Address Address Line 2 Suburb Post Code
Relationship*
3. Residency
Are you an Australian Citizen or Permanent Resident?*
- Yes
- No
Do you have a right to work in Australia?*
- Yes
- No
Do you have a VISA?*
- Yes
- No
If yes, what type
Any work restrictions
Provide VISA Number*
Are you of Aboriginal or Torres Strait lslander descent?*
- Yes
- No
ls English your preferred language?*
- Yes
- No

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6. Inductions
Please supply details of all Inductions currently held

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8. Employment History
Two most recent positions.
Company Name*
Position Held*
Start Date*
Date Format: DD slash MM slash YYYY
Finish Date*
Date Format: DD slash MM slash YYYY
Contact Name*
First Last
Contact Number*
Daily Tasks*
Reason for Leaving*
Company Name*
Position Held*
Start Date*
Date Format: DD slash MM slash YYYY
Finish Date*
Date Format: DD slash MM slash YYYY
Contact Name*
First Last
Contact Number*
Daily Tasks*
Reason for Leaving*

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10. Workers Compensation History
Have you made any previous Workers Compensation Claims?*
- Yes
- No
Date of Injury*
Date Format: DD slash MM slash YYYY
Name of Employer*
Address of Employer*
Street Address Address Line 2 Suburb State Post Code
Nature of Injury*
How did the Injury Occur?*
Name of Insurer*
Duration of Absence off Work*
Has Claim been resolved?*
- Yes
- No
Was there an award made in your favour for permanent impairment in respect of the claim, if so, what loss or losses?*

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13. Pre-Employment Screening
Prior to employment you will be subject to a urine drug screen and a hearing test. This will be undertaken at the company’s expense, if you fail the urine drug screen you will incur the cost of the drug screen which will be up to $70. I hereby authorise D&D Traffic Management or its representative to release the results of my pre-employment screening to any authorised person or people for the purpose of progressing my application.
Will you participate in the pre-employment hearing test?*
- Yes
- No
Will you participate in the pre-employment urine drug screen?*
- Yes
- No
Will you participate in on the job urine drug screen?*
- Yes
- No

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14. References
Minimum of 2 references to be supplied
Contact Name*
First Last
Position*
Contact Number*
Contact Name*
First Last
Position*
Contact Number*
15. How did you hear about D&D Traffic Management?
Advertising
- Yes
- No
Word of Mouth
- Yes
- No
Website
- Yes
- No
D&D Employee (enter details in comments below)
- Yes
- No
Comment
16. Supporting Information
Please attach any additional certifications, tickets, licences and / or resume to support your application.
Attachment
Drop files here or

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17. Video Upload
Please record a short video of yourself answering the following questions. And upload your video here:
Provide a brief description of what are your interests &/or hobbies are outside of work

Please advise of the work you do now what is involved & why you are now looking to undertake Traffic Control

Please advise as why you have chosen & believe you would be best suited to work with D&D

Please describe what (work wise) you hope to be doing in 2 years’ time

The video is to be no longer than 2 minutes in length.
18. Application Declaration
Name*
First Last
Todays Date*
Date Format: DD slash MM slash YYYY
I certify that the answers, information and statements made in this application form are correct and to the best of my knowledge.*
- I certify that the answers, information and statements made in this application form are correct and to the best of my knowledge.
I understand this information may be subject to verification and I authorize the company to approach any and all third parties identified by me and included in this application for this purpose. I hereby authorize all third parties specifically identified by me in this application to release to the company such information as it may reasonably require verifying the information that I have disclosed in this application.*
- I understand this information may be subject to verification and I authorize the company to approach any and all third parties identified by me and included in this application for this purpose. I hereby authorize all third parties specifically identified by me in this application to release to the company such information as it may reasonably require verifying the information that I have disclosed in this application.
I understand that to supply information, which is false or misleading as part of this application is extremely serious. I understand that to be employed on the basis of falsified or misleading information would subsequently give the company grounds to immediately terminate my employment.*
- I understand that to supply information, which is false or misleading as part of this application is extremely serious. I understand that to be employed on the basis of falsified or misleading information would subsequently give the company grounds to immediately terminate my employment.
I understand that I may be liable for all costs incurred by the company as a result of falsified information D&D Traffic Management reserves the right to reject an application based on evidence presented.*
- I understand that I may be liable for all costs incurred by the company as a result of falsified information D&D Traffic Management reserves the right to reject an application based on evidence presented.
Phone
This field is for validation purposes and should be left unchanged.

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Applying with D&D Traffic Management

Step 1 of 11

1. General Details

2. Emergency Contact

3. Residency

4. Qualifications / Certificates / Tickets

5. Drivers License & Declaration

Driver Declaration

6. Inductions

7. Traffic Control Experience

8. Employment History

9. Fitness for Work

10. Workers Compensation History

11. Commitment

12. Availability

13. Pre-Employment Screening

14. References

15. How did you hear about D&D Traffic Management?

16. Supporting Information

17. Video Upload

18. Application Declaration

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