APPLICATION FORM...Please return this Application Form to the attention of Ross Davidson, Training...
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s:\training\scholarships\forms\cfmeu scholarships application.docx APPLICANT DETAILS Surname: ____________________________________ First Names: __________________________________ Age: (Years) _________________________ (Months) ___________ Dob: ___________________________ Home Address: ____________________________________________________________________________________ Phone: (Home) ________________________________________ Mobile: _______________________________ Email: ___________________________________________________________________________________________ PERSONAL DETAILS Do you have any medical conditions that would impact on your ability to work in your chosen trade? Yes No If Yes, please specify: ______________________________________________________________________________ Do you suffer from any allergies? (If Yes, please specify): ___________________________________________________ Do you have any: (ie. Working at heights; confined spaces) __________________________________________________________ GUARDIAN DETAILS Full Name of Guardian: _________________________________________________________________________ Address of Guardian: _________________________________________________________________________ Guardian’s Union: ____________________________ Union No.: __________________________________ Contact Phone for Guardian: _________________________ Does Applicant Live at home? Yes No APPLICANT SIGNATURE: ________________________________ DATE: ______________ GUARDIAN SIGNATURE: ________________________________ DATE: ______________ APPLICATION FORM Do you have a Drivers Licence? Yes No Are you prepared to join the Union? Yes No
Transcript of APPLICATION FORM...Please return this Application Form to the attention of Ross Davidson, Training...
s:\training\scholarships\forms\cfmeu scholarships application.docx
APPLICANT DETAILS
Surname: ____________________________________ First Names: __________________________________
Age: (Years) _________________________ (Months) ___________ Dob: ___________________________
Home Address: ____________________________________________________________________________________
Phone: (Home) ________________________________________ Mobile: _______________________________
Email: ___________________________________________________________________________________________
PERSONAL DETAILS
Do you have any medical conditions that would impact on your ability to work in your chosen trade? Yes No
If Yes, please specify: ______________________________________________________________________________
Do you suffer from any allergies? (If Yes, please specify): ___________________________________________________
Do you have any: (ie. Working at heights; confined spaces) __________________________________________________________
GUARDIAN DETAILS
Full Name of Guardian: _________________________________________________________________________
Address of Guardian: _________________________________________________________________________
Guardian’s Union: ____________________________ Union No.:
__________________________________
Contact Phone for Guardian: _________________________ Does Applicant Live at home? Yes No
APPLICANT SIGNATURE: ________________________________ DATE: ______________
GUARDIAN SIGNATURE: ________________________________ DATE: ______________
APPLICATION FORM
Do you have a Drivers Licence? Yes No Are you prepared to join the Union? Yes No
s:\training\scholarships\forms\cfmeu scholarships application.docx
EDUCATION HISTORY
Name of School and Grade completed:
School Subjects and Results:
SUBJECT RESULT SUBJECT RESULT
________________________________ ________ ___________________________ ________
________________________________ ________ ___________________________ ________
________________________________ ________ ___________________________ ________
EMPLOYMENT HISTORY
WORK EXPERIENCE Name of Company Brief Details of Work Performed
PAID EMPLOYMENT Name of Company
Brief details of Work Performed
WHAT IS YOUR PREFERRED TRADE? Number 3 boxes in order of preference ie 1,2,3.
Construction
Plastering Bricklaying Shopfitting
Tiling Formwork/Carpentry Painting
Civil Construction
Bituminous Surfacing Bridge Construction & Maintenance Pipe Laying
Road Construction & Maintenance Timber Bridge Construction & Maintenance Road Marking
Plant Operating
Certificate III
Concreting Dogging Scaffolding
Steelfixing Rigging
Please return this Application Form to the attention of Ross Davidson, Training Manager
CFMEU, Construction & General Division, QLD/NT Branch,
16 Campbell Street, Bowen Hills Qld 4006
Ph: (07) 3231 4600 Fax: (07) 3231 4699 Email: [email protected]
OFFICE USE ONLY
Trade: _________________ Employer: ___________________ Start Date: _______________ Apprentice No: ____________
NOTE TO APPLICANT
Please include any supporting documents and/or information to supplement your Application.
Eg. References, Certificates and any other relevant information
