New Employee Setup Form OLH

Employee Details

Name*

Title First Name Preferred Surname

Email*

Date of Birth*

DD

MM

YYYY

Gender*

Male
Female

Address*

Address Suburb State Postcode

Home Phone*

Mobile*

Emergency Contact Details

Name*

First Name Surname

Relationship*

Home Address*

Address Suburb State Postcode

Mobile*

Work Phone*

Home Phone*

Email*

Primary Account Details

Account Name*

Name Of Institution*

BSB (Bank / Branch Number)*

Account Number*

Secondary Account Details

* You may elect to have some of your pay directed into a secondary account.

Account Name

Name Of Institution

BSB (Bank / Branch Number)

Account Number

Amount

Note: Any remaining balance will be paid into your Primary Account

Job Active Details

We work in conjunction with Job Active providers.

If you are registered with a Job Active provider, we may be able to access support to supply any out of pocket costs associated with your employment.

Tools for work – Transport - Company Uniforms Vests, hard hats, boots - Additional Training, Vaccinations – Medicals, specific to your role, Drug testing etc.

Are you registered with a Job Active Provider?*

Yes
No

If yes, who is your Job Active Provider?

Which suburb is your Job Active Provider located in?

I give permission for my records to be accessed*

Yes
No

Authorisation

Employee Name

Signature

1300 629 700