Temporary Employment Opportunities
Personal Details Tip
*Salutation:   *First Name:   *Last Name:  
*Gender:   *Phone:  
*Postal Address:   *Suburb:  
*State:   *Postcode:   *Country:  
*Email: Mobile:

Australian Residency Tip
Are you an Australian citizen or permanent resident?
(If you are not an Australian citizen or permanent Resident, you will be required to have a work visa.)
If "NO", please answer the following questions:
Have you applied for permanent residency?
Do you hold an appropriate work visa?
If "YES", what is the expiry date Expiry date and/or comments (maximum 250 characters)

Work Preferences
*Please indicate the type of work you are seeking (Select a MAXIMUM of four options) Hold 'Ctrl' button to make multiple selections
  Date available to start
 

Documents (Note: Max file size for documents is 4MB) Tip
*Curriculum Vitae (CV):  
Optionally attach a copy of your covering letter, ensuring it lists the type of work you are seeking and the date you are able to start work.
Cover:

DECLARATIONS

INTEGRITY AND GOVERNANCE DECLARATIONS
CRIMINAL CONVICTIONS DECLARATION
Do you have any current convictions for any offences from any court, or are you currently the subject of any charge pending before court? You do not need to give details of any conviction which you have had declared spent (SPENT CONVICTIONS ACT 1988).
 
Note: A criminal record does not necessarily disqualify an applicant. If rejection of your application is considered solely because of a criminal record, you will be given the opportunity to discuss the matter fully before a final decision is made.
Completion of a National Police Clearance will also form part of pre-employment checks.
DISCIPLINARY DECLARATION
Do you have any current disciplinary proceedings in progress against you, or have you previously been subject to a disciplinary process by an employer?
 
Note: A disciplinary process does not necessarily disqualify an applicant. If rejection of your application is considered solely because of a disciplinary record, you will be given the opportunity to discuss the matter fully before a final decision is made.
VOLUNTARY SEVERANCE
Have you received a voluntary severance payment within the last two (2) years from the Western Australian Public Sector?
 
If ‘Yes’, what is your re-entry date on your Deed of Severance:
 
HEALTH DECLARATION / WORKERS’ COMPENSATION
HEALTH DECLARATION
To the best of your knowledge, do you have a medical condition that will preclude you from undertaking the duties of the position you have applied for?
  If Yes, please give details

  Details of medical condition that preclude you from undertaking the position's duties.
WORKERS COMPENSATION CLAIM DECLARATION
Please indicate if you have a current Workers' Compensation claim.
 
Note: A previous Workers' Compensation Claim is NOT a barrier to the consideration of an application for employment. Your answer will be used to assist in assessing opportunities for your placement in appropriate employment.

Additional Information
Please complete the following additional information. The information supplied does not form part of the selection process and will only be used for statistical and process improvement purposes.
 
*Where did you hear about the Temporary Employment Register?
  If Other please specify:
*Are you currently residing out of Australia:   
*Are you of Aboriginal or Torres Strait Islander descent:    

APPLICANT DECLARATION
• By submitting this application I am declaring all statements in the application to be true and correct, to the best of my knowledge, at the time it was submitted.
• I acknowledge that the information I am providing will be relied on in assessing my application and that if I am appointed to this position any significant information that is found to be false or misleading may make me liable for disciplinary action including possible dismissal.
• I understand that appointment with the Department of Mines, Industry Regulation and Safety is subject to all pre-employment checks/ clearances requirements being met.
• If necessary, I consent to the Department of Mines, Industry Regulation and Safety to check any information provided on this pre-employment declaration with the relevant authorities or sources.
• I understand that should my circumstances change such that any information provided in or with respect to this pre-employment declaration is materially different, it is my responsibility to advise the Department of Mines, Industry Regulation and Safety at the earliest opportunity of the detail of such changed circumstances.
• I have provided the names of two (2) nominated referees and I understand that non-nominated referee can be contacted.
Tick your response

 
If your email address is incorrect, you will not receive a receipt.
If you are not an Australian Resident, you will be required to have a work visa.
To attach a document from your computer, click "Browse" to scan your files. Once you've found your document, click to add as an attachment to your application.
If you are having difficulties attaching a file, please email it to recruitment@dmirs.wa.gov.au.

Note: Only MS Word or PDF formats accepted.