Buenavista Services - New Employee Intake

1
Full NamePlease provide your full name
Mr.
Mr.
Mrs.
Prefix
First Name
Middle Name
Last Name
2
Date of Birth* This field is required.Please provide your date of birth.
Date
Day
Month
Year
3
GenderWhat gender best describes you?
Male
Female
Other
4
AddressWhat is your main address?
Street Address
Street Address Line 2
City
Please Select
Please Select
QLD
VIC
NSW
ACT
NT
WA
SA
TAS
State
Postal
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
5
Phone NumberWhat is the best phone number to contact you on?
Area Code
Phone Number
6
EmailWhat is the best email address to contact you on?
example@example.com
7
What is the status of your working rights?Are you a Australian Citizen or here on a Visa?
Australian Citizen
Permanent Resident
Working Holiday Visa
Student Visa
Other Visa
8
Visa StatusIf the answer is yes to any of the questions above (except Citizen and Permanent Resident). Please provide the Visa details and expiry date below. If N/A press Submit to continue.
Huge
Large
Normal
Small
Ok
Ok
9
Next of Kin NameWhat is the name of your next of kin?
Mr.
Mr.
Mrs.
Prefix
First Name
Middle Name
Last Name
10
What is their relationship to you?
Spouse (Husband/Wife)
Partner
Parent/Guardian
Sibling (Brother/Sister)
Friend
Other
11
What is their address?
Street Address
Street Address Line 2
City
Please Select
Please Select
QLD
VIC
NSW
TAS
ACT
NT
WA
SA
State
Post Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
12
Phone NumberWhat is their best phone number?
Area Code
Phone Number
13
EmailWhat is their email address?
example@example.com
14
Do you have any pre-existing medical and/or injuries? This also includes ALLERGIES.* This field is required.
YESNO
15
If yes, please state below detailsPlease provide the details of any pre-existing medical conditions/injuries/allergies you have. Also please provide details of any medical plans in place that we need to be aware of. eg. allergies to peanuts - employee has a epipen on him in the case of a reaction.
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Large
Normal
Small
Ok
Ok
16
Doctor's Name
Dr
Dr
Prefix
First Name
Last Name
17
Doctor's Phone Number
Area Code
Phone Number
18
Doctor's Clinic DetailsPlease provide details of your local GP clinic.
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Large
Normal
Small
Ok
Ok
19
Bank Name
20
Account Name
21
BSB Number
22
Account Number
23
What is your Tax File Number?Please provide your tax file number.
24
Have you claimed the Tax Free Threshold on the ATO Tax File Number Declaration Form?
YESNO
25
Do you have a HECS/FEE-HELP Debt?
YESNO
26
Do you have a current superannuation fund?
I have my own and want to use it
I do not have my own. Please set me up with who you use (We use Hostplus)
27
Superannuation Fund DetailsPlease provide the details for your superannuation fund. Fund Name; Membership Name; Account Name; Unique Superannuation Identifier (USI)
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Large
Normal
Small
Ok
Ok
28
Have you filled out the ATO Superannuation Employee form?
YESNO
29
Do you have a Driver's License and/or a Motor Vehicle?* This field is required.
YESNO
30
Personal Motor Vehicle Usage* This field is required.I understand that during my employment with Buenavista Services Pty Ltd as a support worker I may at times need to use my personal vehicle to transport participants. I agree to keep a logbook and claim mileage at $0.80 per km to cover Fuel, Tolls, Vehicle Maintenance, Insurance, Registration and any other costs applicable to the running of a personal vehicle. This is only applicable when transporting Participants and does not apply to getting to and from a Buenavista Services Site. Buenavista Services Pty Ltd is not liable for any costs, accidents, damages or any other costs that may occur from the use of a personal vehicle during a service period. It is agreed that any vehicle to be used needs to be in Good Working Condition and to hold Full Comprehensive Cover Car Insurance. I understand that to drive I need to hold an Australian Driver's License - Probationary or Unrestricted. I agree to drive safely and appropriately according to the Driving Laws of Australia, understanding that I represent Buenavista Services Pty Ltd whilst using my vehicle. I agree if asked to put a Buenavista Services Sign Magnet on the side of my car whilst ‘on shift’ to advertise Buenavista Services in the community.
31
What is your Driver's License Number?
32
What type of Driver's License do you hold?
Probationary 1 (Red P's)
Probationary 2 (Green P's)
Unrestricted
Other (Bus/Truck License)
33
State of IssueWhat state is your license issued?
QLD
NSW
VIC
TAS
SA
WA
ACT
34
Expiry Date
Date
Day
Month
Year
35
Driver's License UploadPlease upload a photo of the FRONT and BACK of your license
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
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36
What is the Make, Model and Year of your Vehicle?
37
What is your Vehicle Registration?
38
What is your Registration Expiry Date?
Date
Day
Month
Year
39
Registration UploadPlease upload your registration papers
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
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40
Comprehensive Insurance Company Name
41
Insurance Expiry Date
Date
Day
Month
Year
42
Insurances UploadPlease upload a copy of your comprehensive insurance
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Select files to upload
Max. file size: 10.6MB
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43
100 Point Identification CheckRequirements for the ID Check. Note: it might be easier to download this form.
44
Upload Your Primary Identification DocumentPlease upload a primary identification document
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Select files to upload
Max. file size: 10.6MB
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45
Upload Your Secondary Identification Document 1Please upload a secondary identification document
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Select files to upload
Max. file size: 10.6MB
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46
Upload Your Secondary Identification Document 2Please upload a secondary identification document
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
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47
Upload Your Secondary Identification Document 3Please upload a secondary identification document
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Select files to upload
Max. file size: 10.6MB
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48
NDIS Worker's Screening Check - Yellow Card (QLD)
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
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49
Working with Children Check - Blue Card (QLD)
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Select files to upload
Max. file size: 10.6MB
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50
Current First Aid/CPR Certificate
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
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51
Police Check
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Select files to upload
Max. file size: 10.6MB
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52
COVID19 Safety Training Certificate
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Select files to upload
Max. file size: 10.6MB
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53
COVID19 Vaccination Certificate
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
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54
NDIS Worker Orientation Module 'Quality, Safety and You' Certificate
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
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55
Code of Ethics and Conduct* This field is required.Staff / Volunteer Agreement 1. CODE OF CONDUCT The NDIS Code of Conduct requires workers and providers who deliver NDIS supports to: • Act with respect for individual rights to freedom of expression, self-determination, and decision-making in accordance with relevant laws and conventions • Respect the privacy of people with disability • Provide supports and services in a safe and competent manner with care and skill • Act with integrity, honesty, and transparency • Promptly take steps to raise and act on concerns about matters that might have an impact on the quality and safety of supports provided to people with disability • Take all reasonable steps to prevent and respond to all forms of violence, exploitation, neglect, and abuse of people with disability • Take all reasonable steps to prevent and respond to sexual misconduct. Our Code of Ethics and Conduct Policy requires the organisation’s personnel to commit to: • Act with integrity, • Act honestly always. • Be transparent when making decisions or giving advice. • Ensure all actions can withstand scrutiny. • Respect and courtesy • respect the individual’s rights to freedom of expression, self-determination, and decision-making in accordance with laws and conventions. • Act fairly and equitably. • Respect others, their values and their rights. • Respect privacy and confidentiality. • Create a safe work environment that is free of abuse, violence, discrimination, harassment or victimisation. • promptly take steps to raise and act on concerns about matters that may impact the quality and safety supports and services provided to our participants. • take all reasonable steps to prevent and respond to all forms of violence against and exploiting neglect and abuse of. people with disability • take all reasonable steps to prevent and respond to sexual misconduct. • When dealing with one another, management, participants and service users, external stakeholders and other agency representatives, staff members will be respectful, honest and courteous. • Staff members will give accurate information and prompt attention and observe fairness and equity in their dealings with others. 2. WORKING WITH PARTICIPANTS When interacting or working with people using our services, staff will: • Always treat service users with respect, and be mindful of their rights to privacy and confidentiality • Always show respect for people’s cultural or religious sensitivities or requirements, and ensure the responsiveness of the service to their needs and circumstances • Uphold the rights of people with disability, including their rights as consumers • Facilitate informed decision by participants in a person-centred approach which supports and reflects their preferences and expectations • Ensure that service users are provided with, and understand, all information relevant to their situation, options available to them and conditions of use for the service • Ensure they have access to independent advocacy or support if they require in making any decisions • Be aware of personal boundaries and never enter a sexual relationship with a service user • Treat all people in a manner that demonstrates respect and ensures their environment is safe, taking all reasonable steps to prevent any activities that will impact on the quality and safety of the services provided. • Report to supervisor any potential or real risks of harm to the person with a disability. • Not accept money or other gifts 3. STANDARDS IN THE WORKPLACE All staff members are required to: • Attend work in the times agreed, notify delegate officer of their absences, report and account for all leave taken, record attendance and obtain approval before changing their work times • Comply with the requirements of their duty statements and agreed work plans, paying appropriate attention to quality and detail in their work • Provide accurate and honest information to delegated officer about work completed and challenges experienced in completing work • Follow instructions that are reasonable and lawful and within their capability and training • Report any suspected corrupt or fraudulent practices of others. Any staff member making a report will be protected from reprisal • Observe the requirements for conditions of employment and safety as described in our Workplace Health and Safety Policy • Perform their duties unaffected by alcohol or the use of drugs other than those prescribed for them by a medical practitioner • Maintain a harmonious, co-operative and productive workplace, respectful of diversity • Ensure they do not use their position to exert inappropriate influence over others 4. STANDARDS OF WORK All individuals will perform their duties as well as they can and at the highest level of professional conduct. They will be accountable for their work and their interactions with others. • Accountability: • Work within the goals and objectives of the organisation • Follow the rules, policies and procedures of the organisation • Act within the law • Undertake all duties in a diligent manner • Not act in a way that brings them or the organisation into disrepute • Personal behaviours: • Work cooperatively as a member of the team • Support colleagues and treat everyone with respect and courtesy • Discuss ethical concerns with colleagues and managers • Project a positive image of the organisation • Not be absent from duties without an appropriate reason • Maintain confidentiality 4.1 Confidentiality and Privacy All staff and management must respect and keep confidential internal matters of the organisation and respect the privacy of others. 4.2 Harassment and Bullying Harassment and bullying are unacceptable and contrary to ethical behaviour. Additionally, harassment based on a person’s sex, race, ethnic religious background, age, pregnancy, marital status, disability, transgender (transsexual) status or sexuality breaches anti-discrimination and human rights law. Harassment in the workplace can take many forms. It can be obvious or subtle, direct or indirect. It includes: • Sexual or suggestive remarks or gestures • Displaying or circulating sexually suggestive, offensive or degrading/insulting material (e.g. on walls, computer screen savers, email) • Making fun of someone, spreading rumours, and unwelcome practical jokes • Obscene or unsolicited telephone calls, letters, faxes or email messages • Invasion of personal space, unnecessary physical contact • Continually ignoring or dismissing someone’s contribution • Pushing, shoving or jostling or assault • Threats, insults, name calling, inappropriate language • Creating a hostile feeling or environment, even when there are no direct attacks being made on a person Complaints concerning harassment or bullying should be actioned according to the Compliments, Complaints/ Feedback Policy. 4.3 Reporting Unethical Behaviour If a person believes that the behaviour of any staff member, or management is unethical they must report it to delegated officer. Unethical behaviour is defined as: • Workplace behaviour that is contrary to our codes of ethics or conduct, and other workplace policies • Workplace behaviour that violates any law, or is corrupt conduct or misconduct • Mismanagement of resources or fraudulent behaviour • Behaviour that creates a danger to public health or safety or the environment 5. TEAMWORK Staff members will: • Work together towards agreed work objectives and goals and communicate regularly with one another about progress. • Work together to look for ways to improve work methods and to solve workplace and service related problems • Give support and guidance to each other, ensure appropriate training and development and recognise each other’s results and achievements
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Privacy and Confidentiality* This field is required.I agree to the following terms, which form part of my employment conditions. The employee acknowledges that in the course of their employment at Buenavista Services Pty Ltd they may have access or become acquainted with the written materials and other confidential health information, and agrees: a) To maintain the confidence of the confidential information and to prevent unauthorised disclosure to or use by any other person, film or company. b) To only use confidential information for the purpose of carrying out their duties whether that be during employment or after it has ceased. c) Not to remove any part of the confidential information from the premises of the employer without written consent of the employer. d) Not for any reason appropriate, copy, memorise or in any manner reproduce or part with any confidential information. e) On termination of their employment or else when required to do so by the employer, return any and all of the confidential information including any copy of that information, in whatever form that takes. f) When borrowing manuals/information they will return it wholly and in good condition at the time required by the employer. I have read and understand the Privacy and Dignity Policy and Procedure, the Consent Policy and Procedure and the Information Management Policy and Procedure. I understand if I am found to be in breach of this Privacy and Confidentiality Agreement, I will face disciplinary action.
57
Photo Consent Release* This field is required.I hereby give Buenavista Services Pty Ltd consent to record, videotape and photograph my image and/or voice to be used and identified (by name or as part of a group) in the following ways (check all that apply): - Company intranet accessible by employees only - Company internet accessible via the World Wide Web to anyone - Published employee newsletter - Published client/customer newsletter - Published annual report - Social Media which includes Facebook, Instagram, Pinterest, WhatsApp, Tik Tok, YouTube, Twitter or any social media platform Buenavista Services Pty Ltd is being represented. - Other I further understand that no special compensation will be provided to me for use of my image and that I may not be informed in advance of the specific use of my image.
58
I give Buenavista Services Pty Ltd permission to use my image and likeness as listed in the previous screen
YESNO
59
I blanks have read everything that is in this employee form and I agree to everything that is in it. I agree to uphold to the requirements of Buenavista Services Pty Ltd and will adhere to the policies and procedures of this company. I agree to represent the company at all times.
60
Full Name
First Name
Last Name
61
Date
Date
Day
Month
Year
62
Signature
Clear
Should be Empty: