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Job Application Form

Thank you for your interest in a position with the Le Max Group. As part of the recruitment process, please fill out the following online form which will assist us in processing your application.

Please fill in all information relevant to you, to assist us with your application.

*Required

Application Details

Position applied for :

Preferred Role:

Preferred Department:

Location:

Leo's Fine Food & Wine - Hartwell

Leo's Fine Food & Wine - Heidelberg

Leo's Fine Food & Wine - Kew

Maxi Foods - Upper Ferntree Gully

Le Max Group - Head Office

Employment Type:

Full Time

Part Time

Casual

Personal Details

Entitlement to Work

Are you an Australian or New Zealand Permanent Resident or Citizen?: Yes No

What is your Visa class?
What is the date of your Visa Expiry?
Upload a copy of your Visa Entitlement Document:

Have you been convicted of a criminal offence (excluding minor traffic infringements)?: Yes No
Do you give permission for Le Max Group to conduct a Police Check on you?: Yes No

Employment Record

Current Employment

Company Name & Address	Position Held	Gross Salary (per week)	Reason for leaving

Previous Employment

Company Name & Address	Position Held	Date From/To	Reason for leaving

Company Name & Address	Position Held	Date From/To	Reason for leaving

Company Name & Address	Position Held	Date From/To	Reason for leaving

Referees

Please provide contact details of two references who may be contacted, one work related if applicable

Name	Company	Position	Contact Number

Name	Company	Position	Contact Number

Availability

Please indicate the times during the week you are available

	Monday	Tuesday	Wednesday	Thursday	Friday	Saturday	Sunday
Earliest Start
Latest Finish

How many hours per week are you available to work?
Are you available to work public holidays?: Yes No
Are you available to work during Easter, Christmas and New Year?: Yes No
Are you available to work during school holidays?: Yes No
Do you have any planned / booked vacations?: Yes No

Please specify date and duration:

Do you have any commitments that may interfere with your work attendance?: Yes No

Please provide details

Students: Do you have any tests or exams that may interfere with your work attendance?: Yes No

Please specify date and duration

If you are successful with your application, when would you be available to start?

Education

Are you currently studying?: Yes No

What are you studying?

Secondary School & Higher Education

Name of Institution	From date	To date

Qualifications & Training

What relevant skills/training do you have?

Please specify

Health & Safety

Do you suffer from any pre-existing illness or injury that may affect your work performance?: Yes No

Please provide details

Do you take any medication?: Yes No

Please provide details

Do you suffer from any allergies?: Yes No

Please provide details

Have you ever made a claim for Work Cover?: Yes No

Please provide details

General

How did you hear about this position?

Please specify:

Which Employment Agency?

Additional Comments

Attach Cover Letter:
Attach Resume:

I declare that, to the best of my knowledge, the information provided in this application is a true and correct record of my personal details, qualifications and experience. I accept that should my application be successful, the information provided, will form part of my Contract of Employment. I understand that providing false information is grounds for dismissal. I am prepared to submit to an examination by a medical officer nominated by Le Max Group, if so required, at any time regarding any fitness for duty.

I Agree

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