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Application Cover Sheet
To assist in processing your application, please complete this form and submit it with your
application.
Position applied for:
Reference Number:
Position Title:
Personal details:
Title:
Choose an item.
Surname:
Given name:
Address for correspondence:
Date of birth (optional):
May we contact you at work?
Choose an item.
Daytime Contact Phone Number:
Alternative Contact Phone Number:
E-mail Address:
Please note: under subsection 22(8) of the Public Service Act 1999, employees must be Australian citizens
to be engaged in the APS unless the delegate has agreed, in writing, to the contrary. The NBA requires
that candidates be Australian citizens or permanent residents who are eligible to apply for citizenship and
have evidence that they are in the process of doing so.
I am an Australian Citizen: Yes No
Current employment details:
Choose an item.
If yes, Name of Department/Agency:
AGS number:
Substantive Classification: Choose an item.
Actual Classification: Choose an item.
Do you have an Australian Government Security Clearance?
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