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Employment Application

Personal Details



Contact Details





I am currently a resident/Citizen of Australia:

I am currently on a Visa:

Background Check

I am happy to provide my consent for a National Police Check to be completed by Junction Moama if required.


Health and Safety

I do not have any pre-existing injuries or medical (including physiological) conditions that would effect my ability to perform the role(s) that I have applied for at Junction Moama.


If YES - We would appreciate you sharing some details with us to ensure that we provide you with a suitable and safe working environment.


Hospitality Certification

I currently hold a valid:



Employment Requests

I am looking for employment on the following basis (tick as many boxes as suit your requirments):


I am available to work as follows:

Mon Tues Wed Thurs Fri Sat Sun

Days (5am-5pm)

Evenings (5pm-3am)

If your availability should change within your probationary period and no longer meets the needs of the business, we reserve the right to discontinue your employment. All requests will be treated case-by-case.

2 Work Based Referees



are they aware that they have been listed as a referee :




are they aware that they have been listed as a referee :


I am interested in employment with Junction Moama because:

Any Questions or Comments you wish to make

Where did you hear of us?




NOTE: Please read the following. By ticking 'I Agree' will be regarded as your signature.


To Junction Moama to obtain information from any person concerning my suitability for employment with Junction Moama and I hereby release any such person from liability for any damage, claims, costs, expenses which may arise from the provision of such information.

I further declare that the statements made by me in the application are true, complete and correct.

I understand that a false or misleading answer to any question in this application will be regarded as misconduct and will be grounds for my dismissal for employment.

I also understand that that my resume which includes my education and work history MUST BE submitted for this application to be considered.


Resume Attached