French Marriage Certificate Sample by dby13999


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									                                                                 VPS New Employee Personal Details

      To be completed by all new employees within a Public Service unit of DEECD.
       The information collected on this form is required to confirm information provided in the online resume and
       application. We require this information to enrol you on our systems such as IT and payroll.
       Privacy The information collected on this form is for the purpose set out above and is required to enrol you on our systems.
       The collection and processing of this information is in accordance with relevant legislation, regulations made from time to time,
       any ministerial orders, instructions and policies issued by the Department and any applicable federal award and /or
       agreement. DEECD may disclose some of your personal information, as applicable, to outside organisations/bodies that
       require this information to assist with providing employment services such as taxation, superannuation and salary packaging.
       You are able to request access to the personal information that we hold about you, and request that it be corrected by
       contacting Corporate HR Services on 9637 2403 or the Freedom Of Information (FOI) Unit on 9637 2670. Information about
       the Department’s privacy policy can be found at

      A:      Completing the Personal Details Form (Refer to the stated Sections in the form.)
       Personal particulars must be completed in full. Your first given name must be entered as shown on your birth
       certificate unless you have changed your first name officially. Do not use shortened names.
       Optional Information: Your answers to these optional questions helps the Department plan staff recruitment,
       retention and development strategies and to meet government statistical reporting requirements. Personal
       identification details (name, address, work location) are not used for reports.
       Ancestry describes your ethnic or cultural heritage you identify with most. Examples include; Aboriginal
       (Koorie)/Torres Strait Islander, Australian, Maori, English, Irish, Italian, Greek, Turkish, Scottish.
       Language/Linguistic Background: Record your proficiency to read, speak or write a language or languages other
       than English. AUSLAN also falls into this category.
       Sensory Disability: indicate here if you have a sensory disability eg: legally blind, legally deaf, physically disabled.
       Indicate if you have previously worked in a salaried position within this Department.
       Indicate if you have previously received any form of departure / separation package from a Victorian Public Sector
       employer within the past 3 years. If such a package has been received, indicate the date received and from which
       Government Department (Agency) you received it.
       List the contact details of up to two people who could be contacted if an emergency situation.
       Check the details you have entered on this application to ensure they are accurate and correct, then sign and date
       the application.
B:     Employment Checks
        All persons selected for employment are required to complete a form consenting to the Victoria Police checking for
       and releasing details of a criminal record. Employment will not be confirmed until proof of a satisfactory police
       records check is received.
        All persons selected for employment are required to satisfactorily complete the relevant pre employment medical
       requirements to confirm that they are fit to undertake the duties of the position. Employment cannot occur until the pre
       employment medical requirements are met.
C:     Documentation To Accompany Personal Details Form.
       Please supply copies, which have been certified by a person authorised to witness the statutory declaration. (See list as
       part of this form.) If any documents are in a language other than English, authorised translations are also required. Note
       that if you provide originals, they may not be returned to you. Attach all documents securely to your application.

                                                                                                                      Last updated 1 April 2011
All applicants are required to supply the following documentation
(Tick to indicate documentation provided.)  VPS New Employee Personal
1. Evidence of date of birth                Details
   Provide a copy of a birth certificate, or extract of birth entry, or passport, or certificate of naturalisation or certificate
   of citizenship. Note that baptismal certificates or drivers’ licences are not acceptable.
2. Evidence of change of name - if your name is now different from that on your evidence of date of
   Provide evidence, which shows both your current and former name eg. Copy of certificate of marriage, certificate of
   registration of change of name, deed poll, or (if the change was not formally recorded in documents) a statutory
   declaration attesting to the name change.
3. Evidence of permanent resident status - if you are not an Australian or New Zealand citizen
   Provide a copy of the relevant pages from your passport showing a stamp, which confirms your right to permanent
   residence in Australia. Your name must appear on the copy. If you are a British subject who migrated to Australia
   prior to 1974, evidence of residence in Australia prior to 1974 is required. New Zealand citizens are regarded as
   Australian citizens for employment purposes, but evidence of New Zealand citizenship is required. If you are not a
   permanent resident, but have a work permit that allows the type and duration of work for which you are applying,
   such evidence must be provided.


                                                         Country of Birth
       Afghanistan      Czechoslovakia       Italy                          New Zealand       South America (Other)
       Africa (other)   Denmark              Japan                          Norway            Spain
       Albania          Egypt                Korea                          Other             Sri Lanka
       Argentina        England              Laos                           Pakistan          Sweden
       Armenia          (Other)              Latvia                         Peru              Switzerland
       Australia        Finland              Lebanon                        Philippines       Syria
       Austria          France               Lithuania                      Poland            Taiwan
       Belgium          Germany              Macedonia                      Polynesia         Thailand
       Bosnia           Greece               Malaysia                       Portugal          Timor
       Cambodia         Hong Kong            Malta                          Rumania           Tonga
       Canada           Hungary              Mediterranean (Other)          Russia            Turkey
       Caribbean        India                Melanesia                      Samoa             Ukraine
       Chile            Indonesia            Mexico                         Scotland          United States of America
       China            Iran                 Middle East (Other)            Serbia            Vietnam
       Colombia         Iraq                 Myanmar                        Slovakia          Wales
       Croatia          Ireland              Netherlands                    Slovenia          Wales
       Cyprus           Israel               New Guinea                     South Africa

                                                                                                            Last updated 1 April 2011
                                                VPS New Employee Personal
Code   Description              Code   Description              Code   Description
 KR    (Koorie) Aboriginal       GE    German                    PO    Portuguese
 AG    Afghani/Pashto/Pusht      GS    German/Swiss/Austrian     RO    Rumanian
 AK    African                   GR    Greek                     RU    Russian
 AF    Afrikaans                 HK    Hakka                     SA    Samoan
AL     Albanian                 HE     Hebrew                   SB     Serbian
AS     American Sign Language   HI     Hindi                    SR     Serbo-Croatian
AM     Amharic                  HM     Hmong                    SN     Sinhalese
AR     Arabic                   HO     Hokkien                  SL     Slovak
AN     Armenian                 HU     Hungarian                SV     Slovenian
AI     Asian (other)            IA     Indian (Kannada)         SM     Somali
BH     Bahasa (Indonesian)      IK     Indian (Konkani)         SO     South Pacific (other)
BO     Bengali                  IS     Indonesian               SP     Spanish
BS     Bosnian                  IT     Italian                   SI    Swahili
BU     Burmese                  JA     Japanese                 SW     Swedish
CC     Chinese (Cantonese)      KI     Kiswahili                TA     Tagalog (Philippines)
CM     Chinese (Mandarin)       KO     Korean                   TM     Tamil (Ceylon)
CH     Chinese (Other)          LO     Laotian                   TI    Tamil (India)
CS     Chinese (Shanghai)       LT     Latin                    TE     Telugu
CR     Croatian                 LA     Latvian                  TT     Tetum/Timor
CZ     Czech                    LI     Lithuanian               TH     Thai
DA     Danish                   MC     Macedonian               TO     Tongan
DU     Dutch                    MA     Malay                    TU     Turkish
DF     Dutch-Flemish            ML     Maltese                  TW     Twi (Ghana)
EN     English                  ME     Melanesian               UK     Ukrainian
EU     European (other)         MD     Middle Eastern (other)   UR     Urdu (Pakistan)
FA     Farsi (Persian)          NO     Norwegian                 VI    Vietnamese
FS     Finish                   OL     Other Languages          WE     Welsh
FL     Flemish                  PH     Polish                   YD     Yiddish
FR     French                   PL     Polynesian

                                                                                        Last updated 1 April 2011
                                                                             VPS New Employee Personal Details

      The form must be completed and returned to: VPS HR Services, Ground Floor, 2 Treasury Place, East Melbourne 3002.
      1. Personal Details
                                                                                                                          Gender              Male
  Family Name                                                                                                                                 Female

  Given Name/s                                                            Preferred Name                                  Birthdate       ____ / _____ / _____
   Residential         ___________________________________________________________________________________________________
    Address            House Number and Street

                       ______________________________________________                       __________
                       Suburb or Town and State                                             Postcode

      Postal           ___________________________________________________________________________________________________
     Address           Post Office Box /House Number and Street
  (If different to
      above)           ______________________________________________                       __________
                       Suburb or Town and State                                             Postcode

  Contact Details         Home Phone:                                               Mobile Phone:
  If you are not                are a permanent resident.                                                                 Please provide evidence of a
  an Australian                                                                                                           passport, citizenship, residency or
  citizen, please               are a New Zealand citizen.                                                                work permit to VPS HR Services.
  indicate if you:              have an appropriate work permit. Expiry date of permit ___ / ___ / ___
  Optional Information
  As part of the Department's reporting responsibilities, diversity information is required to be collected. Data will be aggregated and individual
  information will not be distinguishable in reports. This information will not be used for any other purpose.
  Country of birth
                                                                             What is your ancestry?
  (See Examples on instruction sheet))

  What is your language/linguistic background?
  (See Examples on instruction sheet))
  Please Indicate your proficiency to read/speak/write this language:
  Read         High           Med              Low           Speak High       Med       Low                Write High                Med         Low
  Are you of Aboriginal or Torres Strait Islander origin?                                 Do you have a sensory disability?
     No         Yes, Aboriginal             Yes, Torres Strait Islander                                      No                     Yes

2. Employment in the Victorian Public Service
Have you been previously employed by this Department?                      No       Yes      If Yes, state former record number:          0____________

3. Voluntary Departure Package
Have you received any form of departure / separation package from a                  No          If Yes, date received              ____ / ____ / ____
Victorian Public Sector employer within the last three years?                        Yes         Agency responsible                 __________________
4. Emergency Contacts This information will be used by DEECD in the event of an emergency.
   Contact 1

  Name                                                                                      Relationship

  Address       _ ___________________________________________________________                          _ __________________________               __________
                     House Number and Street                                                             Suburb or Town and State                  Postcode

  Home phone                                              Work phone                                              Mobile Phone

   Contact 2

  Name                                                                                      Relationship

  Address       _____________________________________________________________                          ___________________________               __________
                     House Number and Street                                                             Suburb or Town and State                  Postcode

  Home phone                                              Work phone                                              Mobile Phone

 5. Declaration I declare that the information I have provided is true and correct .

  Signature of employee             _____________________________________________________________                       Date _            ___ / ____ / ____

                                                                                                                                      Last updated 1 April 2011

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