Moolarben Coal Operations Contractor Approval Form

Moolarben Coal Operations Contractor Approval Form - Underground

Please complete all mandatory fields in separate form for each inductee
Site Contact Details
Site Contact*
Site Contact Email
example@example.com
Company Details
Company Name*
Requester Name*

First NameLast Name
Requester Position*
Requester Phone number*
Please enter a valid phone number.
Requester Email*
example@example.com
Date of Request*

DayMonthYear
Date
Reason for Induction*
Inductee Details

Select a role for each area the inductee will be working in
Full Name*

First NameLast Name
Date of Birth*

DayMonthYear
Date
Occupation*
Contractor Category*
WHSE Number*
What role will the inductee be carrying out on site - Underground?*

Moolarben -Underground Surface - Administration AssistantMoolarben -Underground Surface - Beltman/SplicerMoolarben -Underground Surface - Cable/Joiner/Layer/RepairerMoolarben -Underground Surface - CarpenterMoolarben -Underground Surface - Civil EngineerMoolarben -Underground Surface - CleanerMoolarben -Underground Surface - Cleaner High PressureMoolarben -Underground Surface - Confined Space WorkMoolarben -Underground Surface - DoggerMoolarben -Underground Surface - DrillerMoolarben -Underground Surface - Fire TechnicianMoolarben -Underground Surface - Forklift OperatorMoolarben -Underground Surface - Fuel Delivery DriverMoolarben -Underground Surface - GeologistMoolarben -Underground Surface - Hydraulic Hose TechnicianMoolarben -Underground Surface - Instrument TechnicianMoolarben -Underground Surface - LabourerMoolarben -Underground Surface - Leading HandMoolarben -Underground Surface - Light Vehicle MechanicMoolarben -Underground Surface - Lubrication TechnicianMoolarben -Underground Surface - Mining EngineerMoolarben -Underground Surface - NDT TechnicianMoolarben -Underground Surface - Non Slew Crane OperatorMoolarben -Underground Surface - PainterMoolarben -Underground Surface - Plant OperatorMoolarben -Underground Surface - PlumberMoolarben -Underground Surface - Poly Pipe WelderMoolarben -Underground Surface - RiggerMoolarben -Underground Surface - ScaffolderMoolarben -Underground Surface - Slewing CraneOperatorMoolarben -Underground Surface - Trades AssistantMoolarben -Underground Surface - Trainer/AssessorMoolarben -Underground Surface - Water Treatment AdvisorMoolarben -Underground Surface - WelderMoolarben -Underground Surface - Welding SupervisorMoolarben -Underground Surface - Working at HeightsMoolarben -Underground - BoilermakerMoolarben -Underground - ContractorMoolarben -Underground - Statutory RoleMoolarben -Underground - Supervisor
What relevant qualifications does the inductee have for the nominated site role?*
What experience does the inductee have to perform the planned tasks on site for the nominated role? *
Please upload a copy of your Practicing certificate*

Acceptable file formats are pdf, doc, docx, xls, rtf, or zip. Maximum file size in 500Kb
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MANDATORY REQUIREMENT - Please upload a copy of the Letter of Competency (LOC) for the above applicant.*

Acceptable file formats are pdf, doc, docx, xls, rtf, or zip. Maximum file size in 500Kb
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Please upload any supporting documentation for the applicant mentioned above (e.g Trade papers, diplomas, SOA's)

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IMPORTANT NOTE: This approval is only for the person named to attend the Moolarben Induction. ALL requirements under the persons selected job role must be met through the Avetta Contractor Booking Portal before induction authorisation will be considered
Acknowledgement

I acknowledge the above statement and have attached all required supporting documentation to this application.
Should be Empty:

Moolarben Coal Operations Contractor Approval Form - Underground

Site Contact Details

Company Details

Inductee Details

IMPORTANT NOTE: This approval is only for the person named to attend the Moolarben Induction. ALL requirements under the persons selected job role must be met through the Avetta Contractor Booking Portal before induction authorisation will be considered