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Employment Application


    Basic Information

    Title

    First Name*

    Last Name*

    Preferred Name/Alias

    Address*

    City/Suburb*

    State*

    Postal Code*

    Home Phone

    Mobile Phone*

    Language/s

    Position Applied For - Select one or more *

    Experience*

    Working with Children Check Number

    NSW Police Check Number

    Upload Resume

    Support Work Preferences

    Disability supportPersonal care - simplePersonal care - complexDementia supportMental health supportEnd of lifeSocial supportDomestic assistanceMeal preparationRespite supportShoppingTransportBowel careHoistPEG feed

    Polo Shirt Size

    smallmediumlargex-largexx-largexxx-large

    Availability

    Monday

    Tuesday

    Wednesday

    Thursday

    Friday

    Saturday

    Sunday

    Availability for overnight/public/school holidays

    School HolidaysSleepovers / OvernightPublic Holidays

    Medical Condition

    Do you have a medical condition that could impair or prevent you from carrying out the duties of the position you are applying for? *

    YesNo

    Medical Condition Details*

    Have you ever made a worker's compensation claim? *

    YesNo

    Claim Details*

    References

    (Please provide two recent work-related references)

    Employment reference contact*

    Organisation*

    Phone Number*

    Period of your Employment*

    Employment reference contact*

    Organisation*

    Phone Number*

    Period of your Employment*

    Superannuation Fund

    Name of Super Fund

    Superannuation Pollicy Number

    Tax File Number

    Bank Account Details

    Bank and Branch

    BSB

    Drivers License

    Drivers License Number

    Class

    Expiry Date

    Please Note

    This information will be used solely for the purposes of your employment with Moylan Care Group. We will never share your personal information with any person or organisation unless we have your written permission to do so, or are required to by law or subpoena.

    Applicant Signature

    Date / Time*