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Contact Details
Title *
Legal First Name *
Legal Last Name *
Preferred Name
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Phone (W)
Mobile
Email *
Email Confirmation*
 
Residential Address
Address 1 *
Address 2
City / Town *
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Post Code *
Country *
 
Resume
 
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Access Password (for future online application/s)
Username
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Password *
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Confirm Password *
 
  

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Have you ever been employed by WorkSafe Victoria?*    
Contract Type *
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Employment Type *
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How did you hear about WorkSafe Victoria?
Preferred Location  *
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Work Rights *
Expected Salary
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Category / Sub-Category *



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