Cohort Staffing Care Application

Cohort Staffing Employment Application Form
- Position applied for:*
- Employment type:*
  
  Full TimePart TimeCasualContractor
- Title
- First Name:
- Middle Name:
- Last Name:
- Your Name:*
  
  PrefixFirst NameMiddle NameLast Name
- Any preferred name?
- Do you have any preferred name(s)?*
  
  YesNo
- Add all of your preferred name(s):*
- Have you ever been known by any other name?
- Have you ever been known by any other name(s), including maiden names?*
  
  YesNo
- List all of your previous name(s), including maiden names:*
- Are you of Aboriginal and/or Torres Strait Islander origin?*
  
  NoYes, AboriginalYes, Torres Strait IslanderPrefer not to say
- Gender*
  
  MaleFemaleOtherPrefer not to say
- Date of Birth:*
  
  DayMonthYear
  Date
- Address:*
  
  Street Address
  
  Street Address Line 2
  
  SuburbState
  
  Post code
- Mobile Phone:*
- Personal Email:*
  example@example.com
- Contact 1 Name:*
- Contact 1 Phone:*
- Contact 1 Email:*
  example@example.com
- Contact 2 Name:
- Contact 2 Phone:
- Contact 2 Email:
  example@example.com
- Do you have evidence of qualification?*
  
  YesNo
- Available to commence work on:*
- Availability timings:*
- Previous Relevant Employment
- Please provide two professional referees, this must include one current manager. Please note references are contacted once an offer is made.
- Do you agree to have referees contacted for this position?*
  
  YesNo
- Referee 1 *
- Referee 2
- Given the nature of the work, can you please confirm whether you have any pre‐existing injuries or illnesses that may be affected by this work?*
  
  YesNo
- Do you have any health issues that can prevent you from extensive digital work?*
  
  YesNo
- Details of pre-existing injury or illness:
- There might be travel involved for work. Are you comfortable to travel long distances for work if needed?*
  
  YesNo
- Are you ok to work in mostly digital ways of working?*
  
  YesNo
- NOTE: failing to notify or hiding any relevant pre-existing injury, illness or work limitation could result in that injury or illness being ineligible for future compensation claims, and/or termination in employment and/or may result in legal action.
- Do you have a current Australian police check?*
  
  YesNoHave Applied
- Are you required to provide an International Police Check? Applicants who have lived overseas for 12 months or longer in one country in the last 10 years are required to provide an international police check for each country.
  
  YesNoHave Applied
- To work for Cohort Staffing you need legal work rights in Australia. E.g
  - An Australian Citizen, permanent resident of Australia, or New Zealand citizens who have entered Australia on a valid passport and are allowed to stay and work in Australia without restriction. (A birth certificate, citizenship certificate or current
    passport is proof of eligibility).
  You will need to provide documents as evidence of your right to work and Cohort Staffing will also check the visa details on VEVO, an online system on the Department of Immigration and Citizenship’s website for employers to check the visa details of a prospective employees.
- Do you consent to Cohort Staffing to check the visa details on VEVO (if on a visa)?
  
  YesNoN/A (I am not on visa)
- Name on Passport:
- Date of Birth:
  
  MonthDayYear
  Date
- Country of Issue:
- Passport No.:
- Signature
- Date*
  
  DayMonthYear
  DateHourMinutesAM/PM Option
- Cohort Staffing will treat all information obtained in a strictly confidential manner and will not release any information to any other party unless authorisation to do so has been obtained from the applicant.
  Please send the form & other requested documents to: hr@cohortstaffing.com.au
  
  Please attach below requested documents to process your application. For missing documents, please leave a note below.
  - Identity Document (e.g. Passport or Birth Certificate)
  - Drivers Licence (both sides)
  - Proof of Address (Drivers' Licence, recent utility bill, or bank statement)
  - Proof of Work Rights (e.g. Australian Passport, VEVO check, Australian Birth Certificate, etc.)
  - Current Police Check (Not required if you have a valid NDIS Clearance check)
  - Current International Police Check – if applicable (Applicants who have lived overseas for 12 months or longer in one country in the last 10 years are required to provide an international police check for each of those countries.)
  - Covid-19 Vaccination Certificate
  - NDIS Worker Screening Check - clearance (If Applicable)
  - Working with Children Check - Employee – (If Applicable)
  - Proof of any relevant Qualifications
  - Other (e.g. professional registrations)
- Identity Document
  
  Browse Files
  E.g. Passport or Birth Certificate Cancelof
- Drivers Licence
  
  Browse Files
  Both Sides Cancelof
- Proof of Address
  
  Browse Files
  E.g. Drivers' Licence, recent utility bill, or bank statement Cancelof
- Proof of work rights
  
  Browse Files
  Australian Passport, VEVO check, Australian Birth Certificate, etc. Cancelof
- Current police check
  
  Browse Files
  
  Cancelof
- Current International Police Check
  
  Browse Files
  
  Cancelof
- Covid-19 Vaccination Certificate
  
  Browse Files
  
  Cancelof
- NDIS Worker Screening Check - Clearance
  
  Browse Files
  
  Cancelof
- Working with Children Check
  
  Browse Files
  
  Cancelof
- Proof of any relevant Qualifications
  
  Browse Files
  
  Cancelof
- Birth Certificate:
  
  Browse Files
  
  Cancelof
- Change of Name Certificate:
  
  Browse Files
  
  Cancelof
- Marriage Certificate:
  
  Browse Files
  
  Cancelof
- Other Documents
  
  Browse Files
  e.g. Professional Registrations Cancelof
- Notes:
- Please email any other requested documents to: hr@cohortstaffing.com.au
- Should be Empty:

Cohort Staffing Employment Application Form