Employer CSQ Declaration 20-21

Employer Construction Skills Queensland (CSQ) Declaration 20/21
EMPLOYER TO COMPLETE
Employer Name
Position
Contact Number
ABN
Employee Details
Employee Name Employee Name First Last
Role description/Job Title
Length of Employment
Employment Capacity
Funding Type (please check)

Funding Type (please check) Short Course – Civil Construction Short Course – General Construction SAGT – Civil Construction SAGT - General Construction Higher Level Skills (not eligible to AAP) Short Course – Major Project
Major Project Name
They will be completing training in the following region:
Civil Safety Office
CHECKLIST

I Declare that my employee:
I Declare that my employee:	YES	NO	NA
Is an existing worker or eligible worker in the Building and Construction industry	Is an existing worker or eligible worker in the Building and Construction industryYES	Is an existing worker or eligible worker in the Building and Construction industryNO	Is an existing worker or eligible worker in the Building and Construction industryNA
Is an existing worker on a Major Project (Major project funding only)	Is an existing worker on a Major Project (Major project funding only)YES	Is an existing worker on a Major Project (Major project funding only)NO	Is an existing worker on a Major Project (Major project funding only)NA
Is employed in Queensland (this is only required if the employee does not live in Queensland)	Is employed in Queensland (this is only required if the employee does not live in Queensland)YES	Is employed in Queensland (this is only required if the employee does not live in Queensland)NO	Is employed in Queensland (this is only required if the employee does not live in Queensland)NA

Has been carrying out the below listed tasks:
DECLARATION
I declare that the information provided above to be true and correct. I support my employee in applying for the above CSQ funding Program which is a Construction Skills Queensland initiative.
Name Name First Last
Employer Signature (Draw your signature into the box below.)

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
Date Date / DD / MM YYYY