Blue-Collar Contractor Application
Status
Who's It Sitting With?
Applicant Name
*
First Name
Last Name
Who Is The GM³ Engagement Initiator?
*
If you're unsure - who would be the best GM3 employee to contact if further details are needed regarding this application?
Date of Birth
*
Please select a month
January
February
March
April
May
June
July
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December
Month
Please select a day
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Day
Please select a year
2010
2009
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Year
Role
*
Company
*
Company Contact Email
*
example@example.com
Does the contract company have a valid contract with GM³?
*
Yes
No
Has the applicant had any claims to Coal Mines Insurance?
*
Yes
No
Please list each claim with details of both the date and injury as a separate line item
*
Has the applicant worked in the coal industry before?
*
Yes
No
What is the total number of years that the applicant has worked in the coal industry?
*
Has the applicant been an employee of GM³ previously?
*
Yes
No
If so specify location, last position held and period of employment
*
Is the applicant currently working at another GM³ site?
*
Yes
No
If yes, which site and who is the employer?
*
Is the applicant banned from any GM³ site?
*
Yes
No
Number of years with current employer?
*
If less than 2 years, state previous employer, time employed and role:
*
Details of work experience (role, types of work/skills e.g. development, longwall):
*
Site Selection
*
Appin
WCCPP
Dendrobium
DCPP
Cordeaux
Logistics Services (incl. Kemira Valley)
Mine Services
Training
Cleaning Services
Technology
Health
Work Area
Appin Work Area Owner
*
Maintenance - Surface
Engineering - Surface Mechanical
Engineering - Surface Electrical
Operations - Surface
Operations - UG Services
Operations - Development
Operations - Longwall
Operations - Coal Clearance
Operations - Projects
Operations - UG Maintenance
Statutory - Electrical
Statutory - Mechanical
Statutory - Mining
Warehouse
Technical Services
Environment
Appin Vent Shaft 7/8 Project
Appin Contract Work Area Owner Email List
Maintenance - Surface
Engineering - Surface Mechanical
Engineering - Surface Electrical
Operations - Surface
Operations - UG Services
Operations - Development
Operations - Longwall
Operations - Coal Clearance
Operations - Projects
Operations - UG Maintenance
Statutory - Electrical
Statutory - Mechanical
Statutory - Mining
Warehouse
Technical Services
Environment
Appin Vent Shaft 7/8 Project
Mine Services Work Area Owner
*
Engineering & PMO
Approvals
Logistics & Sales Planning
Business Process
Contracts
Environment
Mine Services Work Area Owner Email List
Engineering & PMO
Approvals
Logistics & Sales Planning
Business Process
Contracts
Environment
WCCPP Work Area Owner
*
Maintenance - WCCPP
Environment - WCCPP
Statutory - Electrical
Statutory - Mechanical
WCCPP Work Area Owner Email List
Maintenance - WCCPP
Environment - WCCPP
Statutory - Electrical
Statutory - Mechanical
Dendrobium Work Area Owner
*
Maintenance - Surface
Technical Services
Operations - UG Services
Operations - Development
Operations - Longwall
Operations - Projects
Operations - Maintenance
Statutory - Mining
Statutory - Electrical
Statutory - Mechanical
Warehouse
Environment
Dendrobium Work Area Owner Email List
Maintenance - Surface
Technical Services
Operations - UG Services
Operations - Development
Operations - Longwall
Operations - Projects
Operations - Maintenance
Statutory - Mining
Statutory - Electrical
Statutory - Mechanical
Warehouse
Environment
DCPP Work Area Owner
*
Engineering - Process DCPP
Manager DCPP
Engineering - Mechanical DCPP
Maintenance DCPP
Engineering - Electrical DCPP
DCPP Work Area Owner Email List
Engineering - Process DCPP
Manager DCPP
Engineering - Mechanical DCPP
Maintenance DCPP
Engineering - Electrical DCPP
Cordeaux Work Area Owner
*
Environment
Infrastructure
Exploration/Rehab
Maintenance (Site)
Gas Laboratory
Engineering - Electrical
Engineering - Mechanical
Cordeaux Work Area Owner Email List
Environment
Infrastructure
Exploration/Rehab
Maintenance (Site)
Gas Laboratory
Engineering - Electrical
Engineering - Mechanical
Logistics Services
Logistics - Matt Barrett
Kemira Valley - M Lopeman
Logistics Services Email List
Logistics
Kemira Valley
Submit
Internal Use Only
Work Area Owner Email
example@example.com
Work Area Owner Password
Work Area Owner Approval
*
Approved
Rejected
HR Password
HR Approval
*
Approved
Rejected
Rejection Reason
*
Approved Date
-
Day
-
Month
Year
Date
Submit
Sender
Sender Name
Blank
Should be Empty: