This form contains personal information, which will be dealt with in accordance with our
Privacy Policy. If you are successful in your application all the data in this form will become an employment record. If you are unsuccessful your application form will be kept for future re-application.
Health
Your employment will depend on you being fully able to perform the inherent requirements of the position. When completing this health declaration, you must be in full knowledge of the position as outlined in the job description posted in this site. It is not our intention to deny an employment solely because of disability or illness. This declaration does enable, where applicable, appropriate and reasonable action to be taken by Elite to meet the provisions of Division 3 of the Workplace Injury Rehabilitation and Compensation Act 2013 and Section 21 of the Occupational Health and Safety Act 2004.
Section 41 of the Workplace Injury Rehabilitation and Compensation Act 2013, requires disclosure to your employer of any pre-existing injuries or disease that you have suffered, or existing injuries or disease that you continue to suffer of which you are aware and could reasonably be expected to foresee, and could be affected by the nature of the proposed employment referred to above.
Section 21 of the Occupational Health and Safety Act 2004, states that an employer shall provide and maintain, so far as practicable, for employees a working environment that is safe and without risks.
Failure to make a disclosure, or the making of a false or misleading disclosure, may disentitle you to compensation pursuant to the Workplace Injury Rehabilitation and Compensation Act 2013 should you suffer any recurrence, aggravation, acceleration, exacerbation or deterioration of a pre-existing injury or disease arising from employment with Elite. Elite may rely upon any failure to disclose in accordance with the provisions of the Workplace Injury Rehabilitation and Compensation Act 2013 as grounds for denying compensation.
Do you have an existing injury or medical condition pre-existing injury that could be affected by the nature of the proposed employment or may affect your ability to perform the essential requirements of the job? Existing is a medical condition for which treatment is still being received. Pre-existing is where an injury or medical condition/s is present but treatment is not required. If yes please provide details of the injury or medical condition(s).