VisitOz - The Programme

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Your Information

Name: *
Age: *
Gender: *

Home Phone: *
Mobile Phone:
Date of Birth: *

Home Address: *

Email Address: *
Nationality: *

Education and Work Experience

University:
Degree:
Years Attended:
Graduation Date:

Occupation:
Work Experience:
Tax File Number:

Other Skills and Qualifications

Horse Experience:
Tractor Skill:
Do you Smoke:
Mechanical Skills:
Languages:

Can you Cook:
Child care:
Hobbies:
Can you weld:

Do you have a drivers Licence for a:
Tractor Motorbike Truck Car
Manual or Automatic:

Other skills, qualifications:

Travel Information

Arrival Date: *

Date Available: *

Passport Num: *
Travel w/ a friend?
Work w/ a friend?

Town:
Length of Stay: *
Passport Exp: *

Who?
Who?

Outline any special plans or intentions

More Information

Travel and Backpacking Experience

How did you hear about VisitOz

Please write a short description of yourself and the sort of job you would like to have - and where:

Dietary, Medical & Personal

Any special dietary requirements?

Are you a vegetarian or vegan?

Are you undergoing any sort of medical treatment, including medication?

Do you have any physical limitations?

Is your anti tetanus protection in date?

Hospitality Experience

Worked in a hotel?
Worked in a cafe?
Worked in a pub?

Where:
Where:
Where:

Agreement of Information

I hereby apply for the Visitoz Introduction to Agriculture course. I will send the deposit of $280 with this application and will pay by credit card (see the payment slip at the foot of the form) or into the Commonwealth Bank account, this information will be forwarded to you in your welcome email – please fax the receipt when you send in the form. I will pay the balance on arrival with Visitoz in Goomeri on the Monday my course starts. The choice of jobs is provided for all but if my English is not good enough for safety I will not be offered a job where I could get into danger and it may be a work-for-keep job in return for more English lessons. I understand that the standard industry cancellation fees will apply if I cancel less than one week before the start date (50%) or do not show up (100%). I also understand that if I am lazy on the course or do not perform well at my first job Visitoz may not supply second or subsequent jobs. I have and will bring with me: Tax File Number, Visa (IN the passport, not on a piece of paper ‘electronic’), Medicare (British, Swedish, Norwegian, Finnish, Dutch, Italian and Maltese), good medical insurance (all others): working boots (not laced if possible), jeans, long sleeved shirts and sunscreen; a pocket knife, alarm clock, torch (all can be purchased in Goomeri) You will be given a broad brimmed hat (or Visitoz cap), water bottle, beach / shopping bag and t-shirt.

Name: *
Date: *

Email Addresss: *

Credit Card Information I would like to particpate in the 365 day programme. I would like to particpate in the 90 day programme. I wish to pay direct into the bankYes

Because you have elected this option, you will receive our banking details in an email after you have submitted this application. Please use those details to make your payment and then fax us the receipt when it is completed.

I wish to pay by credit card, the easiest, the details are below:-Yes

I hereby authorise Visitoz to charge the sum below to my credit card
$280 $700 $800 $900

Select Card Type: *
Expiry Date: *

Name: *

Card Number: *
Security Number: *

Payment Details

Course Cost = $ AUD Discounts if applicable = $ AUD Payments being made = $ AUD Total cost remaining = $ AUD

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The Programme

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