• Civil Engineering Construction

  • Bulk Tipping Haulage

  • Waste Transport & Disposal

  • Earthmoving Plant Hire  & Contracting

44 Tyrone Place Erskine Park NSW 2759
PO Box 347, Kingswood NSW 2747
OFFICE: [02] 4723 9900
FAX: [02] 4721 1809

MULGOA QUARRIES
Application for Wage Employment

Please ensure that you complete in full details of certificates held and skills/experience sections on page 2 and attach copies of all your certificates.





Employment History for the past 5 years*:


Do you have, or have you ever had, back problems, cardiac or circulatory disease, repetitive
strain injury or any other health problems that may affect your ability to perform the duties required?
If yes, please state the nature of the health issue below or put N/A

Have you submitted a Workers Compensation claim for any condition that may be exacerbated
and/or affect your ability to carry out the duties required?

If yes, please provide details of claim:


Applicants may be required to undergo a medical examination by a Mulgoa Quarries-appointed Doctor, at MQ’s expense, to ascertain suitability for employment. By submitting this application you agree to undergo a medical examination if requested to do so

Declaration:

I declare that the information provided by me in this application is true and correct.
I understand that Mulgoa Quarries will rely on this information to assess my suitability and may
terminate my employment if the information proves to be false or deliberately misleading.