Authority to Obtain Information

PROTECTION OF PRIVACY

I understand that as part of the service provided to me, MADEC Australia may collect information from third
parties about matters relating to my employment, training and other non-vocational matters. I authorise MADEC
Australia to obtain the following information from relevant organisation/s:

Potential Employers, Employers, Labour Hire Organisations and other Host Organisations
• Information relating to employment or potential employment, including my employment history
• Payroll information including wages, payslips and payroll summaries
• Performance and attendance at any employment placement including, but not limited to hours worked
and leave taken
• Skills and training
• References
• Other relevant information as required (including disability if relevant to position)

Training & Education Providers and Apprenticeship/Traineeship organisations

• Training Contracts including Apprenticeship & Traineeship agreements
• Engagement or potential engagement in training courses, including attendance records
• Course particulars
• Other information as required

Work Experience, Work for the Dole or Volunteer Host Organisations

• Attendance records
• Performance and engagement, including employment potential
• Skills/Training
• References
• Other relevant information as required

Any State or Commonwealth Government Department

• Employment status
• Personal information
• Servicing

Declaration by Participant:

By signing below, I confirm

• I understand that information gathered about me by MADEC Australia will only be used or disclosed by
MADEC Australia for the purposes relating to the services I am receiving or as stipulated by any
Government department or agency that fund or administer such services.
• I understand that MADEC will not obtain or release information from/to Medical Practitioners
• I have read, understand and agree to the collection, use and disclosure of my sensitive personal
information in accordance with this agreement form.
• This Authority is valid for 12 months following the cessation of servicing from MADEC Australia
• I am aware that I have an option to opt out of consent with certain parties/organisations at any stage.

__________________________________
Pablo Sicardi ___________________________________
Name Signature

11/04/2022
_________________________
Date The MADEC Privacy Policy is available at www.madec.edu.au

EMP/F/1.3v6 Authority to Obtain Information Date of Issue: 3 February 2021 Page 1 of 1