Application for Summer Crew 2009
The information that you provide will be used to help assess your suitability for employment. It is
therefore in your interest to complete this form accurately and to consider your answers carefully
before writing them down. Your Application and resume must be received by ForestrySA 5pm,
Friday 18th September 2009.
Vacancy Title
Location
Summer Crew GT
Mt Gambier, Mt Burr, Penola
Mrs
Ms
Given Name(s)
Family Name
Birth Date
Postal Address
Suburb
Phone Number
Work
Mobile
Email
Miss
Vacancy No.
Level
Mr
T5863/2009
FMW 3
Dr
Other
State
Post Code
Home
Please tick preferred contact number
Do you hold a current driver’s licence?
Yes
No
Licence Number
Class
Learners Permit
Probationary Licence
Full Licence
Expiry
Are you legally entitled to work in Australia?
Yes, I am an Australian/New Zealand citizen or permanent resident
Yes, I hold a valid work visa
Type
Expiry Date
Please attach evidence if you hold a valid work visa.
Where did you first see the advertisement of this vacancy?
The Border Watch
SE Times
Penola Pennant
Notice of Vacancies
ForestrySA
Website
Other (please specify)
Are you currently employed?
Yes
Please list details of your current employer and your supervisor/manager
Organisation
Employed as
Period of
Employment
Supervisor
Phone No.
Do you authorise ForestrySA to contact this employer?
Yes
No
Give details of your previous 2 employment positions:
Organisation
Employed as
Period of
Employment
Supervisor
Phone No.
Reason for
Leaving
Do you authorise ForestrySA to contact this employer?
Yes
No
Organisation
Employed as
Period of
Employment
Phone No.
Supervisor
Reason for
Leaving
Do you authorise ForestrySA to contact this employer?
Yes
No
Selection Criteria
Do you have any of the following certificates? (If “Yes” tick the boxes)
CFS Level 1 or Basic FireFighter
Plantation Fire Fighting 1
Chainsaw Level 1 Certificate
Current Senior First Aid Certificate
Current MR or HR driver’s licence
Are you a current CFS member?
Yes
No
Brigade:
_______________
Member number:
___________________
Do you have other relevant qualifications or certificates?
Will you be available for standby and fire fighting duties outside normal working hours,
including weekends and public holidays? Yes
No
Have you had experience doing any of the following? (If “Yes” tick the boxes)
Summer crew
Pruning pine trees
Fire fighting
Applying herbicide
Planting trees
Fire tower watching
Farm work
Working in the forest industry
Chainsaw use
Controlling woody weeds (axe work)
Heavy Machinery Skills e.g.
Tractor
Dozer
Grader
Loader
Truck
If you answered “Yes” to any of the above, explain your level of experience:
Do you have any general construction & maintenance skills?
Yrs Experience
Farm
Building Industry
Roadwork
Mining
Forestry/Parks
List Details
Would you accept a job at all locations?
Yes
Please indicate your preference of locality with a 1, 2 or 3?
Mt Burr
Mt Gambier
Penola
If No, which depot(s) would you not work at?
Why do you want this job?
What skills can you bring?
What additional training would you require to fulfil this role?
What is your highest level of education?
Have you worked for ForestrySA (or Woods and Forests), as an employee or a contractor?
Provide Details.
To be employed on the Summer Crew you will need to pass a fitness test. This involves walking 3.22 km with an 11.3 kg
backpack, within 30 minutes.
What activities keep you fit? How often do you exercise?
What have you done in the past to contribute toward a teamwork environment?
How do you decide what gets top priority when scheduling your time?
If your supervisor asked you to do something and you did not understand, what would you
do?
If you saw an unsafe activity at work, what would you do?
Can you give an example of where you have been safety conscious and proactive towards
safety in the workplace?
If you were asked to prune pine trees for a day, how would you keep yourself motivated to
get the job done?
Do you now or have you ever suffered from any of the following complaints?
(You are advised that under the provisions of the Worker’s Compensation Act, Section 90(1) you may not be entitled to
receive compensation for any of the complaints listed below in respect of which you wilfully give a false answer).
* Back disorder
* Dermatitis or similar
* Hernia
* Blood pressure
* Hearing loss
* Heart condition
* Eyesight loss
* Neurosis or nerve condition
* Injury to shoulders, arms, hands or fingers, legs, feet or toes
Other__
________________________________________________________
*If you have suffered, or are now suffering, from any of the above or any other condition, do
you consider that you are restricted from efficiently performing the duties of this position?
Yes
No
Comments
Are you involved in a current claim or are you receiving any payments under the Worker’s
Compensation Act?
Yes
No
Give details
REFEREES
Give contact details for 3 work-related referees, one of whom is your current manager (if possible)
who can provide comments regarding your skills and capabilities. Include day-time telephone
numbers. Explain how you know each person.
Referee 1
Referee 2
Referee 3
ADDITIONAL INFORMATION
If you would like to add any additional information to your application, do so here:
Declaration (this must be completed for your application to be considered)
To the best of my knowledge all information contained in my application provided in support of my
application and disclosed in response to the following questions is true and correct in every respect
(tick appropriate box).
Have you received a voluntary separation or voluntary early retirement package from a South
Australian public sector within the past three (3) year period from the date of your separation?
Yes
No
If YES, please provide date of separation:
Have you ever received any payment, involving your resignation from South Australian public
sector employment, in redemption of a liability under the South Australian worker’s compensation
legislation?
Yes
No
If YES, please provide details of resignation date and name of agency / authority in which
resignation took effect:
Do you currently have any disability or medical condition, which might prevent or impede you from
being able to satisfactorily perform any duties that might be required of you in the position for which
you have applied?
Yes
No
Unsure
If YES or UNSURE, please provide details: (please include details of any assistance / adjustments
what would allow you to carry out the functions of the position)
Please note: If you have any disability or medical position which might require the provision of non standard measure to either provide
you with a safe system of work, or to enable you to satisfactorily perform your duties, you should inform us. This information is
necessary to enable us to provide a safe system of work to you in the event that you are offered employment, which will enable us to
provide appropriate assistance. The provision of any such information will not be used to discriminate against you because of the
existence of any such disability or medical condition.
If you are offered the position do you agree to undergo a medical examination, functional capacity
test, police check and walk test that relates to the functions of the position:
Yes
No
Have you ever been found guilty of any offence? (This includes where a conviction is not recorded
including Road Traffic Act offences)
Yes
No
If YES, please provide details:
Are you currently facing charges yet to be determined for any offence?
Yes
No
If YES, please provide details:
I understand that, if my application for employment with ForestrySA is successful and I am
employed in this position for which I have applied for or in any other position within ForestrySA, I
will not engage in any external or private activities which will result in a conflict or potential conflict
of interest with any of my duties as a ForestrySA employee unless authorised by the Chief
Executive.
I acknowledge that during the course of my employment within ForestrySA, I may gain access to
confidential information. I understand that I must not disclose or make use of the confidential
information, during or after that employment, except in the proper course of my duties. In particular,
I undertake not to use any confidential information gained by virtue of my employment within
ForestrySA, with the intent of securing a benefit for myself, any person, company or future
employer.
I understand that I must return all confidential and sensitive documents and any copies of those
documents, and any other Government property I have in my possession on leaving public
employment at ForestrySA. I also understand that my failure to comply in the way stated above
may result in me being liable for legal proceedings, which could include action for damages or
injunction for breach of confidence.
Should it be considered necessary by ForestrySA, I hereby consent to the release to the person
bearing a written authority from ForestrySA, full details of any person history and any other
relevant information that any Australian State/Federal/Territories Police or Law Enforcement
Agency may have in its possession with reference to me. This includes any convictions imposed
on me that are spent or rehabilitated (however described) under State/Territory/Federal
Legislation.
I acknowledge without this consent being provided, spent or rehabilitated convictions with certain
States may not be disclosed.
In consideration of the release of information, I hereby release and discharge and agree to
indemnify and hold harmless the State of South Australia each of the Australian
State/Federal/Territory Police or Law Enforcement Agencies and their employees, servants and
agents from and against all claims, demands, actions, suits, proceedings, costs and damages
whatsoever arising out of or in any way connected with the release or the use of the information.
This consent form shall remain active until I cease to be an employee/client of ForestrySA.
I declare that the information in this declaration and in any other documents completed by
me in support of my application for employment in ForestrySA, and the information
provided by me during any interviews in connection with my application for employment in
ForestrySA, is true and correct in every detail. I understand that any incorrect statement in
connection with my application for employment in ForestrySA may lead to a rejection of my
application for employment, or in the event that I am offered employment with ForestrySA
may make me liable to disciplinary action which may include dismissal.
Signature
(enter name if electronic)
Date
If you are selected for an interview you will be required to sign this declaration in front of the
interview panel. You will also need to bring along your licence and any relevant qualifications.
Checklist for Applicants
Application form completed in full
Resume
Signed Application
Please email application and resume to forestry.hr@forestrysa.sa.gov.au
All applications must be received by Friday 18th September 2009.
Please contact Jamie O’Neil on 08 87242804 for any queries in relation to your application.
Thankyou for your time and honesty in completing this application.