NEW EMPLOYEE

PERSONAL AND BANKING DETAILS FORM

Given Names: __________________________

Surname: _____________________________

Address: ___________________________________________ Postcode: _________________

Phone: h) ____________________ m) ___________________

Marital Status: _____________

E-mail address: __________________________________________ Date of Birth: ___/___/___

JHC will use this email address to send you your payslips fortnightly and to
communicate relevant hospital information to you.

I have received, read, understand and accept in full the terms and conditions of my contract
of employment dated ___/___/___ Signature: ________________________________
BANK ACCOUNT DETAILS: (for direct payment of salary)
Bank Name:

_____________________________________

Branch Address:

_____________________________________

BSB No: (branch No.)

_____________________________________

Account Number:

_____________________________________

Name/s on Account:

_____________________________________

MULTIPLE ACCOUNT DETAILS:

I authorise the Payroll Department to deduct $_______each payday and forward to:
Bank Name:

_____________________________________

Branch Address:

_____________________________________

BSB No: (branch No.)

_____________________________________

Account Number:

_____________________________________

Name/s on Account:

_____________________________________

EMERGENCY CONTACTS
1. Name _____________________________

Relationship _____________________________

Phone (Work) ______________________

(Mobile) _________________________________

2. Name _____________________________

Relationship _____________________________

Phone (Work) ______________________

(Mobile) _________________________________