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Please complete this form for all Employment enquiries and click the 'send' button to electronically submit your details. Alternatively you may complete the form online, print a hard copy and mail it to us. Use the File/Function in your browser to obtain a hardcopy of the completed details. Please sign the form and mail it with a copy of your current Curriculum Vitae to:

QUICKSILVER CONNECTIONS LTD.
Attention: [Relevant Department]
PO Box 171
Port Douglas
Queensland 4871
Australia

Surname:

Given Names :

Street Address:

City:

State/Province:

Zip/Postal code:

Country:

Phone:

E-mail:

Are you able to legally work in Australia?

Please list any technical/trade, secondary, tertiary qualifications or training or special skills you have relative to the position.

Qualifications:

Please list languages spoken and proficiency that may be relative to the position

Please list previous employers, positions held, period positions held and name under which you were employed.

Employer 1

Address

Position Held

Period Held

Responsibilities

Reference Contact

Employer 2

Address

Position Held

Period Held

Responsibilities

Employer 3

Address

Position Held

Period Held

Responsibilities

Please provide written references [attached to form] or list names and telephone contacts of at least 3 people who may be contacted.

Referee 1

Telephone Contact

Referee 2

Telephone Contact

Referee 3

Telephone Contact

Please provide information regarding any medical history or physical condition which may affect your performance of the inherent requirements of the position or we should be made aware of for safety and welfare reasons.

I consent to any reference checks which may be necessary to support this application and authorise those past employers and referees listed to release personal and performance information relative to this application.