Your representative These are the details of the person or business that is representing you. Name of person Organisation Postal address Suburb State or territory Postcode Phone number Fax number Email address The other party These are the details of the other party covered by the instrument. Title [ ] Mr [ ] Mrs [ ] Ms [ ] Other please specify: First name(s) Surname Postal address Suburb State or territory Postcode Phone number Fax number Email address If the other party is an organisation please also provide the following details Legal name of organisation Trading name of organisation ABN/ACN Contact person 1. Preliminary 1.1 What is the industry of the employer? Please specify the industry.
Your representative These are the details of the person or business that is representing you. Name of person Organisation Postal address Suburb State or territory Postcode Phone number Fax number Email address The other party These are the details of the other party covered by the instrument. Title [ ] Mr [ ] Mrs [ ] Ms [ ] Other please specify: First name(s) Surname Postal address Suburb State or territory Postcode Phone number Fax number Email address If the other party is an organisation please also provide the following details Legal name of organisation Trading name of organisation ABN/ACN Contact person 1. Preliminary 1.1 What is the industry of the employer? Please specify the industry.
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