Name*

Address*

Please read and answer each question honestly, failure to advise Platinum Traffic Services of a pre-existing injury or medical condition may place you at increased risk of injury and may remove your entitlement to claim compensation under Workers Compensation or Accident Compensation Legislation.

In certain circumstances, employment is dependent upon obtaining a satisfactory National Police Check and/or Working with Children Check.

Please complete your most recent employment first.

Please note the names and addresses of two persons from whom we may obtain both character and work experience references.