APPLICATION FOR EMPLOYMENT

All boxes marked with a star * are compulsory fields. Acceptance of your completed Application for Employment by Dobson Family Care in no way implies that you will be offered employment.

Position applied for (If known):

Title*

Name*

First NameLast Name

Address: (No. & Street)*

Suburb/Town /City*

Post Code*

Phone*

Area CodePhone Number

Email Address

example@example.com

Please provide details of your highest level of education (eg. Year 12)

Please provide details of any additional formal qualification(s) (e.g. School Level, Degree, etc.) or equivalent, that you have undertaken

Are you an Australian citizen/permanent resident?

YesNo

If "No", do you have a valid work permit?

YesNo

(If "Yes", please attach a certified copy of your Work Permit or a copy of your Passport including Visa details)

File Upload

Are you currently employed?

Yes:No:

If "Yes", may we contact your current employer?

Yes:No:

Please provide details for your two most recent employers

	Employer	Position Held	Duties/Responsibilities	Date From	Date To
Service Quality
Cleanliness

Please provide details of two Referees who can comment on your skills, performance and achievements. The Referees should preferably be previous Supervisors or Managers

	Referee Name	Relationship to Applicant	Organisation	Position	Contact
Service Quality
Cleanliness

Please provide any additional information that you believe may influence our employment decision

Declaration by Applicant:

1. I agree to participate in all required aspects of the Selection Process, including an NDIS Worker Screening Clearance and Blue Card, and that any information provided to me by Dobson Family Care during this process shall be regarded as CONFIDENTIAL and shall be treated accordingly.

2. I agree that reference checks may be conducted with all or any of the Referees I have identified above.

3. To the best of my knowledge, I have no pre-existing disabilities or medical conditions that would affect my ability to perform tasks as may be required by an employee of Dobson Family Care.

4. Upon request from Dobson Family Care, I agree to provide a Federal Police Check, at my own expense, to support my application for employment.

5. I understand that any misrepresentation of fact in my application for employment provided either in writing or verbally, may result in no offer of employment being made, such offer being withdrawn, or my employment being terminated. Accordingly, to the best of my knowledge, the above information and all other documentation and information provided in support of my application is true and correct.

Applicant Signature*

Date

Application For Employment