Application For Employment Form HomeApplication For Employment For... 1 2 3 4 5 6 7 8 9 10 11 12 13 We are committed to equal opportunity and do not discriminate on the basis of age, race, sex, color, religion, national origin, handicap, or any other legally protected status. It is our goal to provide equal opportunity to all qualified applicants and to make hiring decisions based on job-related criteria. Please double-check that you've filled out the Employment Application Form correctly. If your application is accepted, the Recruitment Manager will contact you through email and WhatsApp to schedule an interview. Personal Details First Name Surname Date of Birth Email Address Mobile Number Street Address Suburb State WAVICSAQLDTASNSW Post Code Country AustraliaUnited StatesCanadaMexicoUnited KingdomAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntigua and BarbudaArgentinaArmeniaArmeniaArubaAustriaAzerbaijanAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaireBosnia and HerzegovinaBotswanaBouvet Island (Bouvetoya)BrazilBritish Indian Ocean Territory (Chagos Archipelago)British Virgin IslandsBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongoCook IslandsCosta RicaCote d'IvoireCroatiaCubaCuraçaoCyprusCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly See (Vatican City State)HondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKazakhstanKenyaKiribatiKoreaKoreaKuwaitKyrgyz RepublicLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyan Arab JamahiriyaLiechtensteinLithuaniaLuxembourgMacaoMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinian TerritoryPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarReunionRomaniaRussian FederationRwandaSaint BarthelemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Netherlands)Slovakia (Slovak Republic)SloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia & S. Sandwich IslandsSpainSri LankaSudanSurinameSvalbard & Jan Mayen IslandsSwazilandSwedenSwitzerlandSyrian Arab RepublicTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkeyTurkmenistanTurks and Caicos IslandsTuvaluU.S. Virgin IslandsU.S. Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUruguayUzbekistanVanuatuVenezuelaVietnamWallis and FutunaWestern SaharaYemenZambiaZimbabwe Previous Next More about you Do you have your own vehicle: SelectYesNo Is the vehicle comprehensively insured?: SelectYesNo Can you drive with no restrictions? SelectYesNo If No, please describe Do you have a superannuation account with a registered super company? SelectYesNo Superannuation Fund Name USI Number Employee Number Address Phone No TFN Number Are you comfortable in driving? As sometimes you need to travel for 10 KM or 20 KM or 30 KM or sometime more as our clients are located in different areas. We will reimburse the number of Kilometers you traveled from client to client. SelectYesNo Previous Next Emergency Contact Details First Name Last Name Relationship Email Address Mobile Number Street Address Suburb State WAVICSAQLDTASNSW Post Code Previous Next How did you hear about us? How did you hear about us? SelectFacebookIndeedInstagramOur clientOur workerOur websiteSupport coordinatorPlan ManagerInternet searchFamily Friends Previous Next Your previous experience Have you previously worked as a Support Worker, Nurse or Cleaner? SelectYesNo Please tell us a little more about your experience as a Support Worker, Nurse or Cleaner. Previous Next Health & Wellbeing Do you smoke? SelectNoYes If yes do you smoke in a car? Do you have any allergies? SelectNoYes Please describe in details Do you have osteoporosis? SelectNoYes Please describe in details Do you have an existing physical, medical or psychiatric condition that we may need to take into consideration when scheduling your work? SelectNoYes Please describe in details Do you, or have you ever had a back/neck injury or pain? SelectNoYes Please describe in details Do you have a bad shoulder injury, leg, knee, hip or bulging spinal discs? SelectNoYes Please describe in details Do you, or have you ever had any other injuries or disabilities that we should take into consideration when scheduling you for work? SelectNoYes Please describe in details Previous Next Employment History (Relevent to this role) Company or Employer Name Position Held From To Reasons for leaving Previous Next Diversity & Inclusion Gender SelectMaleFemalePrefer to self describe Do you identify as Aboriginal and / or Torres Strait Islander? SelectYesNo Are you of a Culturally and / or Linguistically Diverse (CALD) background? SelectYesNo Is English the main language you speak at home? SelectYesNo What other languages can you speak? Do you identify as Lesbian, Gay, Bi-Sexual, Transgender, Intersex and / or Queer?SelectYesNo Previous Next Please list 3 references (2 Must be your past employers or professional references) Reference 1 Name of Referee Contact No Email Name of Organisation Reference 2 Name of Referee Contact No Email Name of Organisation Reference 3 Name of Referee Contact No Email Name of Organisation Previous Next Criminal Declaration Do you have any convictions, finding of guilt and/or pending police charges against you that are less than 10 years old? SelectNoYes Please describe in details Have you been subject to disciplinary proceedings for misconduct or terminated by an employer? SelectNoYes Please describe in details Have you EVER been convicted of theft, fraud, poor driving, drugs, drink driving, assault or aggression to another person? SelectNoYes Please describe in details Are you under Police investigation or have police charges pending for theft, drugs, fraud, poor driving, and drink driving or aggravated assault on another person? SelectNoYes Please describe in details Previous Next Your Availability in a week Day Monday Start Time End Time Day Tuesday Start Time End Time Day Wednesday Start Time End Time Day Thursday Start Time End Time Day Friday Start Time End Time Day Saturday Start Time End Time Day Sunday Start Time End Time Write N/A if you are not available on any day. Overall, how many hours per week are you IDEALLY wanting to work? Previous Next Applicant's Declaration I declare that all statements which I have made on this Application for Employment are correct to the best of my knowledge and belief, and understand that any misstatement of material facts may affect the success of this or any future employment application with the company. I further understand that failure to provide information or falsely stating any information may result in termination of employment. I further understand and accept that my roster (if applicable) may be changed at any time with due regard to relevant awards and/or enterprise agreement conditions. I also accept that I may be required to undertake a pre-employment medical examination by a Company-appointed GP prior to commencing employment. This pre-employment medical will be based around the inherent requirements of the position/s applied for, and any information will be made available to the Company prior to any offer of employment. I also confirm that I am able to maintain the required standards of fitness, safety, courtesy and neatness at all times and observe all rules and policies of the Company including due care and responsibility of Company property, equipment and monies. I agree to actively participate in random drug and alcohol testing as required. I authorize the hiring company to contact former employers and educational organizations regarding my employment and education. I authorize my former employers and educational organizations to fully and freely communicate information regarding my previous employment, attendance, and grades. I authorize those persons designated as references to fully and freely communicate information regarding my previous employment and education. Full Name of the Applicant: Previous Next Documents you should need to upload for Staff Application Note: Please ensure the following documents are uploaded to the application portal Resume, please upload here. Car Insurance or CTP Insurance paperwork (we prefer fully comprehensive insurance), please upload here. Driving License front, please upload here. Driving License back, please upload here. Passport copy (if you are a foreigner), please upload here. Current Police Check (if you are foreigner and here in Australia in less than 10 years, please provide international police check), please upload here. First Aid Certificate, , please upload here. Working with Children Card (If you have), please upload here. Manual Handling Certificate (If you have), please upload here. Food Handling Certificate (If you have), please upload here. If you're a foreigner, please provide evidence of working or visa, please upload here. NDIS Worker Orientation Completion Certificate, please upload here. Diploma of Nursing Certificate 4 in Aged Care (If you have), please upload here. Certificate 3 in Disability or Individual Support (If you have), please upload here. Certificate 4 in Disability or Individual Support (If you have), please upload here. Certificate 4 or Diploma in Mental Health (If you have), please upload here. Any other relevant qualifications (If you have), please upload here. Seizure Management Certificate - Not compulsory, please upload here. Medication Competency Certificate - Not compulsory, please upload here. Copy of Training Certificates, Other Qualification Certificates (Covid-19 Infection Control by Department of Health), please upload here. Any other certificate or qualification, please upload here. Previous Next
