Application Form
Application Form| Page 1
LEADERSHIP | OUTCOMES | LOYALTY | EXCELLENCE
Position Applied for:
Full Name: _________________________________________________________________
Address: _______________________________ Suburb: ________________________
State: _______________ Post Code: _____________________
Email Address: _____________________________________________________________
Mobile: ____________________
Are you?
A current employee of the City of Ballarat? Yes No
A past employee of the City of Ballarat? Yes No Year employment ended:
Right to Work
Please note that in order to work at the City of Ballarat, you must have the legal right or be in the process
to obtain permission to work in Australia. If you do not currently have that right, you may apply for this
position and the Council may be able to assist you in obtaining that right; however, the Council offers
no guarantee of such assistance.
Are you an Australian citizen? Yes No
If No, please tick appropriate evidence that you can provide:
Certificate of evidence of resident status
Valid visa with work right
Please provide any other information that you identify as being pertinent to this application and your
ability to perform the duties of the role: (eg medical conditions, disabilities, criminal history)
_________________________________________________________________________________
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