APPLICATION FOR EMPLOYMENT

Date

Do you identify as Aboriginal/Torres Strait Islander?

YESNO

First Name

Surname

Date of Birth

Place of birth

State/Country

Do you require a Visa to work in Australia?

YESNO

Please provide a copy of your Visa

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Arrival Date

Type

Email Address

Mobile

Home Ph

Home Address

Suburb

State

Postcode

DETAILS OF EMPLOYMENT

**Please provide details below ( at least the last three positions held )

Position #1

START DATE OF EMPLOYMENT

FINISH DATE OF EMPLOYMENT

COMPANY

POSITION HELD

REASON FOR LEAVING

Position #2

START DATE OF EMPLOYMENT

FINISH DATE OF EMPLOYMENT

COMPANY

POSITION HELD

REASON FOR LEAVING

Position #3

START DATE OF EMPLOYMENT

FINISH DATE OF EMPLOYMENT

COMPANY

POSITION HELD

REASON FOR LEAVING

Position #4

START DATE OF EMPLOYMENT

FINISH DATE OF EMPLOYMENT

COMPANY

POSITION HELD

REASON FOR LEAVING

Position #5

START DATE OF EMPLOYMENT

FINISH DATE OF EMPLOYMENT

COMPANY

POSITION HELD

REASON FOR LEAVING

REFEREES / REFERENCE NOMINEES

Are you willing for Dandelion House to conduct reference checks on your behalf?

YESNO

Referee #1 (Must be previous employment)

Company

Person to contact

Position Title: (Previous Manager)

Business Phone No.

How long have you known Referee #1?

Email

Referee #2 (Must be previous employment)

Company

Person to contact

Position Title: (Previous Manager)

Business Phone No.

How long have you known Referee #2?

Email

Referee #3 (Must be previous employment)

Company

Person to contact

Position Title: (Previous Manager)

Business Phone No.

How long have you known Referee #3?

Email

REQUIRED DOCUMENTS

Please list and attach any of the below documents that you already have.

Required Documents

Resume

Please upload Resume

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NDIS Worker Screening Check

Please upload NDIS Worker Screening Check

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First Aid Certificate

Please upload First Aid Certificate

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Working with Children's Check

Please upload Working with Children's Check OR proof of application (Receipt)

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Drivers licence

Please upload Drivers licence

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Passport or Birth Certificate

Please upload Passport or Birth Certificate

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Vehicle Registration

Please upload Vehicle Registration

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Comprehensive Insurance

Please upload Comprehensive Insurance

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NDIS Worker Orientation Module - https://training.ndiscommission.gov.au//course/index.php?categoryid=2

Please upload NDIS Worker Orientation Module

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Infection Control Module https://dsc-free-courses.s3.amazonaws.com/supporting-people-to-stay-infection-free/index.html#/

Please upload Infection Control Module

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Membership / Registration Certificate

Please upload Membership / Registration Certificate

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If you do not have any of the above documents, would you be willing to obtain them prior to employment?

YESNO

Qualifications

Have you obtained a Certificate IV or above in a related field to this role?

YESNO

If yes please list below what qualification you have obtained and attach a copy of the certificate.

Please attach a copy of the certificate

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Please list any other qualifications have obtained and if possible attached a copy of the certificate.

Please attach a copy of the certificate

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Questions

Are you aware of any pre-existing injuries, illnesses or medical health conditions that could impact your ability to carry out the full range of duties of this role?

YESNO

Give Details?

Are you comfortable providing personal care to both males and females?

YESNO

Do you have a reliable vehicle that you would be willing to transport Clients in?

YESNO

Do you have any relations that are employed or support by Dandelion House?

YESNO

Give Details?

Availability

As our Placements operates 24/7, are you willing to work; day shifts (06:30 – 14:30), afternoon shifts (14:30 – 22:30+Sleepover), night shifts (22:30 – 06:30) , weekends and public holidays?

YESNO

Are you willing to work in both the Newcastle and Maitland area?

YESNO

Are you willing to complete sleepover shifts on a regular basis? (A sleepover shift is where the Staff member sleeps at the placement within a secure room for an 8hour period)

YESNO

How many hours would you ideally want to work per week?

Do you have any future holidays or leave scheduled?

YESNO

Give Details?

If successful, when would you be able to start?

Please indicate in the bellow table what your availability would be over a fortnightly period?

Week 1

Week 2

Monday