Application Form

First Name*
Middle Initial
Second Name*
D.O.B
Gender
Employer*
Employer Contact Details*
Email*
State
Select your primary functional role from the list below. Select up to 4 if you have more than one functional role with 1 being the primary role, eg if qualified Lineworker in a Superviors role, select Team Leader/Supervisor as 1 and Lineworker as 2
1
2
3
4
Please select a Network Operator from the list below based on which Network Operator you are engaged for the majority of your time.
Network Operator*
Are you an Apprentice/Trainee?
No
Yes
Are you a HV Live worker?
No
Yes
Initial or Replacement Passport*
Initial
Replacement
Old passport number

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