Care Worker - Application Form

Care Worker - Application Form

Position Details
HR Email
example@example.com
Position *

Your Personal Details
Your Name*

PrefixFirst NameMiddle NameLast 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(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
Address*

Street Address

Street Address Line 2

SuburbState

Post code
Mobile Number*
Email*
example@example.com
Birth Date*

DayMonthYear
Date
Gender*

MaleFemaleOtherPrefer not to say
Languages Spoken*

EnglishMandarinArabicCantoneseVietnameseItalianGreekTagalog/FilipinoHindiSpanishPunjabiOther
Work Eligibility

To work for Cohort Staffing you need legal work rights in Australia. E.g. an Australian Citizen, permanent resident of Australia. (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 employee.
Do you consent to Cohort Staffing to check the visa details on VEVO (if on a visa)?*

YesNoN/A (I am not on visa)

	Please enter details below
Name on Passport
Date of Birth
Country of Issue
Passport No

Qualifications
Current Qualifications
Are you currently undertaking studying or training?*

YesNo
Course/Program Name:
Frequency:

Full TimePart TimeOther
Expected Completion

Availability
Preferred Start Date*

DayMonthYear
Date
Availability Timings*
Do you agree to do short shifts? (2-3 hours per shift)*

YesNo
Do you have another job?*

YesNo
Days and Hours of other job

0/200

Experience
Previous Relevant Experience OR Placement*
Employment Verification Letter: Please provide a letter from your previous employer/s confirming your role title and length of employment.

Browse Files
This letter has to be on your employer's letterhead. The letter must include position title, start date, end date, duties and number of hours served in the role. Cancelof

Emergency Contact Details
Contact 1 Name:*
Contact 1 Phone:*
04 _ _ _ _ _ _ _ _
Contact 1 Email:*
example@example.com
Contact 2 Name:
Contact 2 Phone:
04 _ _ _ _ _ _ _ _
Contact 2 Email:
example@example.com

References
Please provide two professional referees whom we can contact. By providing the referee details, you authorise us to contact them for the purpose of your work reference check.
Referee 1
Referee1 Name*
Referee1 Phone
Referee1 Email*
Referee1 Employer Name
Referee1 Position Held
Referee 2
Referee2 Name*
Referee2 Phone
Referee2 Email*
Referee2 Employer Name
Referee2 Position Held
Referee 1
Referee 2

Documents
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 the documents below 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)
- First Aid certification
- CPR Certificate
- Car Insurance Certificate
- Proof of any relevant Qualifications
- Resume
- Other (e.g. professional registrations)
Identity Document

Select Files
(e.g. Passport or Birth Certificate) Cancelof
CV / Resume and Cover Letter

Select Files
Please attached your resume and cover letter Cancelof
Drivers' Licence

Select Files

Cancelof
Car Insurance - min. third party with business use

Select Files
(e.g. Comprehensive Car Insurance) Cancelof
Proof of Address

Select Files
(e.g. Drivers' licence, recent utility bill, or bank statement) Cancelof
Proof of work rights

Select Files
(e.g. Australian Passport, Australian Birth Certificate, Visa letter, etc.) Cancelof
International Police Check

Select Files
(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.) Cancelof
Covid-19 Vaccination Certificate

Select Files
Disability workers require 3 doses to work outside their home. Cancelof
NDIS Workers Screening Check - Clearance

Select Files
As a registered NDIS Provider it is essential that our staff have a valid NDIS WSC clearance. If you have applied, please attach confirmation receipt. Cancelof
Working With Children Check

Select Files
Workers who do not have a valid WWCC will not be able to work with children. If you have applied, please attach confirmation receipt. Cancelof
First Aid Certificate

Select Files
Valid for 3 years if it is due to expire in the next 2 months we require you attach a booking confirmation Cancelof
CPR Certificate

Select Files
Valid for 1 year. If it is due to expire in the next 2 months we require you to attach a booking confirmation. Cancelof
Proof of Qualification

Select Files
(E.g. degree certificate, enrolment letter, transcript, etc) Cancelof
Birth Certificate:

Select Files

Cancelof
Change of Name Certificate:

Select Files

Cancelof
Marriage Certificate:

Select Files

Cancelof
Other files

SELECT FILES
NDIS Orientation module certificate, Covid Infection Control certificate, etc. Cancelof
NDIS Orientation Module

https://training.ndiscommission.gov.au/login/index.php

Covid-19 Module (Infection Control)

https://openwho.org/courses/COVID-19-IPC-EN
Notes

0/100

Declaration
Your Signature*

Clear
DateTime
Terms of Use & Privacy - Your application form contains personal information, which will be dealt with in accordance with our Privacy Policy. View our Terms of Use & Privacy Policy. If you are successful, your form will become an employment record. If you are unsuccessful your application form will be kept for six months before being destroyed.

If you any questions completing this form or if you prefer to email your required documents, please contact: hr@cohortstaffing.com.au
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