Staff Pre Employment Collection Form

Expression of Interest in Employment

Position - Disability Support Worker for Minka Blue
Name*

First NameLast Name
Which position are you applying for?*
Which site are you applying for?*
Date of Birth*

DayMonthYear
Date
Phone Number*
Please enter a valid phone number.Format: (00) 0000-0000.
Address*

Street Address

Street Address Line 2

CityState

Post Code
Do you have NDIS Worker Screening Check?*

YesNo
Do you have your Working with children check?*

YesNo
Do you have qualifications that relate to this position?*

YesNoOther
Which Qualification/s do you have or are you currently studying?
Do you have a current Driver's *
Licence Number
Availability: Day shifts through to night shifts starting as early as 6 am:

MondayTuesdayWednesdayThursdayFridaySaturdaySunday
Are you available for Sleepovers at our SIL or in client's homes - if so what night/s?:

MondayTuesdayWednesdayThursdayFridaySaturdaySunday
Active night shifts that range from 10 pm - 8 am:

MondayTuesdayWednesdayThursdayFridaySaturdaySunday
Do you have any hobbies or skills that may come in handy for social and community participation work?
Anything else you would like to tell us?
Upload a resume please

Cancelof
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Expression of Interest in Employment