Declaration
I declare that:
a) I confirm that the above information is complete and correct and that any false or misleading
information will give my employer the right to terminate my employment without notice.
b) I agree that the employer reserves the right to require me to undergo a medical examination.
I understand that should the employer require further information and wish to contact my doctor with a view to
obtaining a medical report, the employer will inform me of their intention and obtain my permission prior to
contacting my doctor. In addition, I agree that this information will be retained on my personnel file during
employment and for up to six years thereafter.
c) I agree that should I be successful in this application, I will, if required, apply for a
National Police Check and/or Working with Children Check as needed. I understand that should I fail to do so,
or should the check not be to the satisfaction of my employer, any offer of employment may be withdrawn,
or my employment terminated.
