Employment Enquiries

(All sections of this form must be completed to be considered for employment with CCR Group)

Declaration:
Please note it is imperative you provide full and accurate information within this section, as failure to comply may result in any future workers compensation claims being denied. This is in accordance with Section 79 of the Workers Compensation and Injury Management ACT 1981 which states: "Where it is proven that the worker has, at the time of seeking and entering into employment in respect of which he/she claims compensation for a disability, wilfully and falsely representing themselves as not having previously suffered from disability, a dispute resolution body may, in its discretion refuse to award compensation which would otherwise be payable." Providing this information to CCR is not a barrier to consideration of employment, but ensures you are placed in the most appropriate role.
By initialling the page below; I confirm that;
- I certify that the information provided in this document is true and completed to the best of my knowledge.
- I understand that failing to notify or concealing pre-existing injury/illness which might affect the nature of work carried out whilst employed by
CCR could result in that injury/illness being ineligible for future compensation claims.

• Understand by completing
  relating to my employment, and give permission for my references to be contacted.
• Have completed this form with true and accurate information to the best of my knowledge, and understand that any deliberately false or misleading information I have given may lead to termination.
• Declare that I am medically fit for the proposed position