Moolarben Coal Operations Contractor Approval Form

Moolarben Coal Operations Contractor Approval Form - Open Cut/Projects

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 - Open Cut/Projects?*

Moolarben -Open Cut - Administration AssistantMoolarben -Open Cut - Auto ElectricianMoolarben -Open Cut - Beltman/SplicerMoolarben -Open Cut - BoilermakerMoolarben -Open Cut - Cable/Joiner/Layer/RepairerMoolarben -Open Cut - CarpenterMoolarben -Open Cut - Civil EngineerMoolarben -Open Cut - CleanerMoolarben -Open Cut - Cleaner High PressureMoolarben -Open Cut - Computer Systems AnalystMoolarben -Open Cut - Confined Space WorkMoolarben -Open Cut - DoggerMoolarben -Open Cut - DrillerMoolarben -Open Cut - Explosive HandlerMoolarben -Open Cut - Fire TechnicianMoolarben -Open Cut - ForemanMoolarben -Open Cut - Forklift OperatorMoolarben -Open Cut - Fuel Delivery DriverMoolarben -Open Cut - GardenerMoolarben -Open Cut - Gas FitterMoolarben -Open Cut - GeologistMoolarben -Open Cut - Geophysical Systems TechnicianMoolarben -Open Cut - GlazierMoolarben -Open Cut - Hydraulic Hose TechnicianMoolarben -Open Cut - Instrument TechnicianMoolarben -Open Cut - LabourerMoolarben -Open Cut - Leading HandMoolarben -Open Cut - Light Vehicle MechanicMoolarben -Open Cut - LinesmanMoolarben -Open Cut - LocksmithMoolarben -Open Cut - Lubrication TechnicianMoolarben -Open Cut - ManagerMoolarben -Open Cut - Mining EngineerMoolarben -Open Cut - NDT TechnicianMoolarben -Open Cut - Non Slew Crane OperatorMoolarben -Open Cut - Open Cut ExaminerMoolarben -Open Cut - PainterMoolarben -Open Cut - Plant OperatorMoolarben -Open Cut - PlumberMoolarben -Open Cut - Poly Pipe WelderMoolarben -Open Cut - Purchasing OfficerMoolarben -Open Cut - Refrigeration MechanicMoolarben -Open Cut - RiggerMoolarben -Open Cut - Safety OfficerMoolarben -Open Cut - ScaffolderMoolarben -Open Cut - Security OfficerMoolarben -Open Cut - Shot FirerMoolarben -Open Cut - Sign WriterMoolarben -Open Cut - Slewing Crane OperatorMoolarben -Open Cut - Store OfficerMoolarben -Open Cut - SuperintendentMoolarben -Open Cut - SupervisorMoolarben -Open Cut - SurveyorMoolarben -Open Cut - Surveyors AssistantMoolarben -Open Cut - Trades AssistantMoolarben -Open Cut - Trainer/AssessorMoolarben -Open Cut - Transport OperatorMoolarben -Open Cut - Tyre FitterMoolarben -Open Cut - Water Treatment AdvisorMoolarben -Open Cut - WelderMoolarben -Open Cut - Welding SupervisorMoolarben -Open Cut - WHS Consultant
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 - Open Cut/Projects

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