This document contains an employee details form collecting personal, residency, health, bank, and emergency contact information. It requests the employee's name, address, date of birth, residency status if not Australian, any illnesses or medications, bank details, next of kin, private health memberships, and whether they wish to join the company social club.

1. Employee Details Form
Employee Details
Personal Details:
Name:
Employee Number: -
Are you known by
Another name:  No  Yes
Address:
Post Code:
Postal Address:
Post Code:
Home Telephone: ( )
Mobile:
Email: @
D.O.B: / /
Residency Details
Are you an Australian Permanent Resident?
 Yes  No
If no, where is your country of birth?
Health
Do you suffer from an illness or disability which may effect your work?
 No  Yes
If yes, please describe, all information will be kept confidential
Are you on any prescribed medication that you think may affect carrying out your duties?
 No  Yes
If yes, please list the medication you are taking
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2. Bank Details Form
Please provide your banking details below for wages to be deposited to
Bank Details
Bank Institution:
Account Number:
B.SB Number: -
Account Name:
Bank Branch:
Nominated Deductions
Please tick if you wish to be part of Valley View Publishing Social Club, if you choose yes,
a weekly debit of $5.00 will be deducted from your wage
Valley View Publishing Social Club  Yes  No
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3. Emergency Details
Personal Details
Next of Kin:
Telephone (work):
Mobile:
Are you allergic to anything?
 No  Yes
If yes, please describe
Private Health Cover
 No  Yes
If yes, please list your membership(s)
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