Step 1 of 2 50% Please fill out the form below and upload your resume to complete your application for an Emerald Grain harvest casual position. There are two forms: the first is a general application form, the second is a pre-employment medical form. You must fill in each section to complete your application. Once you have completed your application, you will see a confirmation appear on the screen. Name* First Last Home Phone NumberMobile Phone NumberEmail* Address* Street Address City State Post Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country What is your current Residency Status*Please SelectAustralian CitizenPermanent ResidentWorking VisaPlease Provide Visa Details* Site where you wish to work?*NSW - ArdlethanNSW - CoolamonNSW - GoolgowiNSW - The RockVictoria - EdenhopeVictoria - ElmoreVictoria - NullawilVictoria - WernethHave you had previous experience in Grain Industry*YesNoPlease provide details about your Grain Industry experience* Do you have any of the following licences / qualifications? Drivers' Licence Forklift Confined Space Fumigation Front End Loader Non Sluing Crane Working at Heights Chemical Users Telehandler Other Please Specify Licences*Previous Experience Grain Classification & Quality Control Weigh Bridge Operation Pest Control Bunker Operation Hopper Attendant Machine and Plant Operations Maintenance of Site and Equipment Other Other Experience* What date would you be available to commence work?* Are you aware that it is compulsory to complete an online safety induction and attend the designated training scheduled for the position prior to commencing employment with Emerald Grain and do you agree to this?* Yes No Upload Resume*Accepted file types: jpg, jpeg, gif, png, pdf, doc, docx.Please note that successful applicants will need to successfully complete training prior to commencement and Emerald Grain may require applicants to complete a pre-employment medical assessment and police check. Random drug and Alcohol testing may be conducted on sites at any time. Emerald Grain cannot guarantee the length of employment nor the hours of employment each week. If employment is expected to go on beyond 3 months, then applicants will be required to complete a full medical and police check. Thank you for completing this form and please complete the Pre-employment medical form and attach your resume prior to submitting your application. PRE-EMPLOYMENT MEDICAL POLICY / PROCEDURE REFERENCE: Fitness to Work Policy Emerald Grain has a duty of care to provide a safe place of work and to ensure employees and contractors are not exposed to hazards. This form will allow us to obtain relevant medical information so we can ensure, as much as possible, that you are able to undertake the role without risk of harm to yourself or others. Please note that it is discriminatory to deny a person employment solely because they have a disability or illness; that is not the intention of this questionnaire. The intent of this questionnaire is to ascertain that you are fit to work at an Emerald Grain site or if further medical assessment is required at an approved provider. All Emerald Grain employees who work at the Melbourne Port Terminal must undergo a full medical with an approved provider prior to their employment being confirmed. Emerald Grain casual staff employed at country storage facilities do not require a full pre-employment medical. However, Emerald Grain reserves the right for employees to have a full pre-employment medical conducted if deemed necessary. Casual staff who are retain by Emerald Grain in ongoing employment for 3 months and beyond will be required to complete a full medical. All details provided will be treated as strictly confidential and will be maintained on your personnel file. Name of Company*Have you ever had, or do you foresee having any difficulties with any of the following?Working in extreme temperatures? (e.g. 0°C to 50°C)*YesNoWhat difficulties do you have with working in Extreme Temperatures* Working in PPE including long trousers, long sleeved shirts, steel cap work boots, high visibility clothing, hearing protection, safety glasses and wearing work gloves?*YesNoWhat difficulties do you have with working in PPE* Working at heights?*YesNoWhat difficulties do you have with working at heights?* Working in dusty environments?*YesNoWhat difficulties do you have with working in dusty environments?* Walking up stairs/ladders?*YesNoWhat difficulties do you have walking up stairs / ladders* Walking on uneven ground?*YesNoWhat difficulties do you have with walking on uneven ground? Sitting / Standing for extended periods of time?*YesNoWhat difficulties do you have with standing / sitting for extended periods of time?* Shift Work*YesNoWhat difficulties do you have with shift work?* Undertaking manual handling tasks including bending, heavy lifting and/or pulling?*YesNoWhat difficulties do you have undetarking manual handling tasks?* Working in confined spaces?*YesNoWhat difficulties do you have working in confined spaces?* Undertaking work with your hands above shoulder height?*YesNoWhat difficulties do you have working with your hands above shoulder height?* Have you ever suffered from:Epilepsy, vertigo or other conditions that cause fainting dizziness or blackouts?*YesNoDetails about your epilepsy, vertigo or other conditions that cause fainting dizziness or blackouts Lung Conditions e.g. Asthma, emphysema, pneumonia?*YesNoDetails about your Lung Conditions* Hearing Conditions e.g. Tinnitus, perforation, hearing loss, past operations, hearing aids?*YesNoDetails about your hearing conditions* Nasal Conditions e.g. Sinusitis, hay fever?*YesNoDetails about your nasal condition* Visual Impairment e.g. Colour blindness?*YesNoDetails about your visual impairment* Do you wear / use any of the following?Glasses*YesNoContacts*YesNoHearing Aids*YesNoBack brace / ankle brace / elbow brace / other support device?*YesNoPlease specify your support device*Claims and Health ConditionsHave you ever filed a workers’ compensation form in Australia or any other country?*YesNoReason for claim(s)* Date(s) of Injury* If multiple, please list one date per line.Date(s) of claim closure* If multiple, please put one date per line.Do you have or have you ever had any health issues or conditions that may affect your ability to perform the inherent requirements of the job that you are applying for?*YesNoDetails* Candidate Decleration* I declare that I have understood the above questions and certify that the information which I have provided is truthful and correct. I understand that if any information is knowingly false or if it is established to be untruthful, my application may not be considered and/or my employment may be terminated. I understand that if I do not disclose the existence of any pre-existing injury or disease that may affect my work, that I may not be entitled to WorkCover Compensation if there is an aggravation of that pre-existing injury in the workplace.