Staff Record

Staff Record

Education and Care National Service Regulations 145 National Quality Standard QA7
Staff Contact Details
Name*

FirstLast
Address*

Street Address

Street Address Line 2

CityState

Post Code
Birth Date*

DayMonthYear
Date
Phone Number*
Please enter a valid phone number.
Emergency Contact Details
Full Name*

FirstLast
Relationship*
Phone Number*
Please enter a valid phone number.
Regulatory Information (copies included)
Upload and tick*

Educational Qualification (Cert III, Diploma or Bachelor), or documentation of working towards.Working with Children Check/VIT RegistrationFirst Aid Training (including Anaphylaxis, CPR, Asthma)Protecting children: Mandatory reporting and other obligations (PROTECT) Certificate.Work Hours (only required for permanent staff and will be added by NERPSA)
Please upload the required documents.

Cancelof
The following sections are for permanent staff only.

All permanent staff please complete and sign the Person in Day-To-Day Charge section. To learn more about what this means, please refer to the NERPSA Staffing Policy at www.nerpsa.com.au.

Please only complete and sign the Educational Leader and/or Nominated Supervisor sections if you have been instructed by NERPSA.
Person in Day-To-Day Charge
I First Name Last Name accept the responsibilities of Person in Day-To-Day Charge of Service Name
Signature of Employee: Signature Date: Date
Educational Leader Only
I First Name Last Name accept the designation of Educational Leader of Service Name
Signature of Educational Leader: Signature Date: Date
Nominated Supervisor Only
I   First Name   Last Name accept the designation of Nominated Supervisor of   Service Name and understand and accept my responsibilities under the Education and Care Services National Law and National Regulations.
Signature of Approved Provider:   Signature   Date:   Date
Signature of Nominated Supervisor:   Signature   Date:   Date
I would like a copy of this document sent to
example@example.com
Should be Empty:

Staff Record

Regulatory Information (copies included)

Person in Day-To-Day Charge

Educational Leader Only

Nominated Supervisor Only