Education Permanent Conversion

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* 1. Your details

Name

Email Address

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* 2. Are you a Together member?

Yes

No

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* 3. What is your membership number (if known)?

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* 4. Employee/Payroll number

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* 5. Do you have permanent hours?

Yes

No

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* 6. How many permanent hours per fortnight? (0-76 hours)

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* 7. How many additional temporary hours do you work per fortnight? (0-76 hours)

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* 8. How long have been working any additional temporary hours

2-4 years

Over 4 years

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* 9. Are you backfilling another employee?

Yes

No

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* 10. If you are backfilling, when will they return? Leave blank if unknown

Please enter date if known

Date