Staff Application Form

Role applying for *

Location you wish to work from *

How Did You Hear About The Position *

Have you been referred to Australian Carers for employment by a current staff member

YesNo

Staff member name *

Have you been employed in this or a related sector previously *

YesNo

In which year did you commence employment in this or a related sector *

Which year did you leave this sector / industry *

First Name *

Middle Name

Last Name *

Gender *

MaleFemaleNon Binary

My Home Address *

Street address *

City *

State *

Postcode *

Date Of Birth *

Mobile Number *

Email Address

Is English your first language *

YesNo

Spoken English level 1 being very low and 10 being perfect *

Are you an Australian Citizen *

YesNo

Do you have a Permanent Residency Visa *

YesNo

Do you have a Visa that allows you to work in Australia *

YesNo

YOU HAVE JUST STATED YOU ARE NOT ALLOWED TO WORK IN AUSTRALIA
ARE YOU SURE ?

passport upload picture is ok *

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Do you have any pre-existing injuries, illnesses or degenerative conditions ( for support workers this role involves lifting, bending, turning and tasks associated with positioning a person ) *

YesNoPrefer not to say

Please provide details *

Management To Review Above

Are you a smoker *

yesNo

NDIS Clearance

Working with Children / Vulnerable people check

Motor vehicle Drivers Licence *

YesNo

Expiry Date of Licence *

State of issue *

Australian Carers Provide in home community supports and a drivers licence is essential for this role
without a drivers licence we will not be able to offer you employment

First Aid Certificate *

YesNo

Date of Issue

Do you have your own motor vehicle *

YesNo

Is your vehicle comprehensively insured *

YesNo

Make and Model *we ask this as some vehicles may be suitable for some participants and not others

Are you happy to have participants in your vehicle to go to Dr appointments or shops etc

YesNo

Resume upload *

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Please upload resume

Are you currently working for any other NDIS provider ( registered or non registered ) or providing services privately utilising your own individual ABN *

YesNoPrefer not to say

Is it your intention to continue your employment with your current employer *

YesNoNot sure

Name of Provider you are currently working for *

Australian Carers match the skills and attributes of our Support Workers with the needs and desires of our NDIS Participants

below are some questions that best enable us to accomplish this

Age Group *

18-2526-3536-4545+

First Language

Other language *

Other Languages Spoken

Other languages Spoken

Assisting With Personal Care

Male Female *

MaleFemaleNon Binary

Qualifications Obtained

Have You Completed Any Courses / Training With Certificates *

YesNo

Other Qualifications *

Certificate Upload *

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Skills / Abilities / Likes

I have Experience in Providing Support / Assistance With

I Have Experience With The Following Equipment

Upload Staff ID photo

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TAKE A CLEAR HEAD SHOT AGAINST A WHITE / VERY LIGHT BACKGROUND | DO NOT TAKE A PICTURE IN THE CAR OR SHOPS OR WITH ANYTHING ELSE IN THE BACKGROUND | WEAR PROFESSIONAL ATTIRE WITH GROOMED HAIR & FACIAL HAIR | THINK OF IT AS IF IT WERE A PASSPORT OR DRIVERS LICENCE PHOTO NOT AN INSTAGRAM OR FACEBOOK PHOTO WITH NO FILTERS | PLEASE NOTE: YOUR ID MAY BE SENT TO PARTICIPANTS BEFORE SUPPORTS

Work Experience

Company

company 1 Start date

Company 1 Finish

Company 2

Company 2 start

Company 2 finish

Your name *

Dated

Declared True and Correct *

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