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Position Applied For: *
Date: *
Complete Name: *
Date of Birth: *
Street: *
City: *
State: *
Email: *
Phone No. Mobile:
Australian Divers License: *
—Please choose an option—YesNo
COVID-19 fully vaccinated (two doses):
YesNo
Smoker? : *
Australian Citizen? : *
—Please choose an option—YesNoIf NO, attach copy of residency/Work Permit by email
Are you a scuba diver?: *
Dive certification level?:
High school from, to level:
College/Uni from, to level:
Please list any specialist training relevant to this position:
Related Experience:
Do you have any physical or medical limitation which may affect your work?: *
If yes provide details below:
Hobbies, interests, sports:
Work Related Skills in Business, Diving, Instructing, Marine, etc:
How or from who did you learn about this position:
Expected Pay Scale:
When Can You Start?:
Work Experience:
(Start with your present or last position)
1. Company Name:
Phone:
Company Address:
Kind of Business:
Your position:
Supervisor's Name:
Employed from:
Employed to:
Describe your duties:
Pay: $:
Per:
Reason for leaving:
2. Company Name :
3. Company Name :
4. Company Name :
I hereby give my permission for Mike Ball Dive Expeditions to contact either the above Companies or the Referees provided in my Resume to obtain a reference:
Yes
Mike Ball Dive Expeditions may keep my Application, Resume and relevant paperwork on file for six months from the date of this submitting this employment application submission:
Please answer the following questions on your past or present medical history with a YES or NO. If you are not sure, answer YES.
Do you regularly take prescription or non-prescription medication?: —Please choose an option—YesNo
History of diving accidents or decompression sickness?: —Please choose an option—YesNo
Asthma?: —Please choose an option—YesNo
A high cholesterol level?: —Please choose an option—YesNo
Frequent or severe attacks of hayfever or allergy?: —Please choose an option—YesNo
Frequent colds, sinusitis or bronchitis?: —Please choose an option—YesNo
Any form of lung disease?: —Please choose an option—YesNo
Pneumothorax (collapsed lung)?: —Please choose an option—YesNo
History of chest surgery?: —Please choose an option—YesNo
Epilepsy, seizures, convulsions or take medications to prevent them?: —Please choose an option—YesNo
Recurring migraine headaches or take medications to prevent them?: —Please choose an option—YesNo
History of blackouts or fainting (full/partial loss of consciousness)?: —Please choose an option—YesNo
Do you frequently suffer form motion sickness (seasick, carsick, etc)?: —Please choose an option—YesNo
History of recurrent back problems?: —Please choose an option—YesNo
History of diabetes?: —Please choose an option—YesNo
History of back, arm or leg problems following surgery, injury or fracture?: —Please choose an option—YesNo
Inability to perform moderate exercise (eg: walk one mile within 12 minutes): —Please choose an option—YesNo
History of high blood pressure or take medicine to control blood pressure?: —Please choose an option—YesNo
History of any heart disease?: —Please choose an option—YesNo
History of ear disease, hearing loss or problems with balance?: —Please choose an option—YesNo
History of bleeding or other blood disorders?: —Please choose an option—YesNo
History of any type of hernia?: —Please choose an option—YesNo
History of ulcers or ulcer surgery?: —Please choose an option—YesNo
History of drug or alcohol abuse?: —Please choose an option—YesNo
History of skin disorders, dermatitis, melanomas, skin cancer, etc?: —Please choose an option—YesNo
Please supply a copy of:
AS2299 Occupational diving medical (with audiogram)
First Aid and Oxygen Therapy certifications
Note: If successful in your application the above certifications must be valid for more than a 90 day period.
SKIPPERS, ENGINEERS AND DECKHANDS
Masters qualifications
Engineering qualifications
Coxswain qualification
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