Employment Application and Personnel Profile

Employment Application and Personnel Profile

Standard online employment application for Keep Up Australia. Please complete all questions using the wording and structure from the source PDF.
Application Consent and Position Details
Applicant consent
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Position applied for
Employment type
Personal Details
Surname
Given Name/s
Preferred Name
Gender
Other gender identity
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Residential Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Postal Address
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Place of Birth
Work Entitlement and Compliance
Entitlement to Work

Other
Entitlement to Work - Other
Are you prevented from lawful employment in Australia because of your visa or immigration status?
Police Check Status
Emergency Contact and Driver Details
Next of Kin Full Name

First NameMiddle NameLast Name
Relationship to Next of Kin
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Address
Current Driver’s License
Driver’s License Number
Driver’s License Expiration Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Reliable Car with Up-to-Date Registration and Vehicle Insurance
Availability and Current Employment
Date available to commence work

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Do you have any planned leave or holiday within the next 3 to 6 months?
Planned leave date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Returning to work on

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Weekly availability
Currently employed?
May we contact your employer?
Education, Training, and Referees
Qualification title
Institution
Year completed
Current first aid training?
First aid expiry date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Current CPR training?
CPR expiry date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Other skills and training
Languages spoken
Employment referee contact person

First NameMiddle NameLast Name
Employment referee telephone number
Please enter a valid phone number.Format: (000) 000-0000.
Employer 1 details
Employer 2 details
Workplace Injury and Health Declarations
I have read and understand the summary of Workplace Injury Rehabilitation and Compensation Act 2013 Section 41
Do you have any pre-existing injuries or diseases?
Details of any pre-existing injury or disease and how it occurred
Have you received a position description for the role applied for?
Do any injuries or diseases affect your ability to fulfill the position requirements?
Industry Qualifications and Client/Participant Preferences
Industry related qualifications

Other
Industry related qualifications - Other
Client/participant preferences
Comfort working with LGBTI Community
Comfort working with Aboriginal or Torres Strait Islanders
Comfort providing personal care
If not comfortable providing personal care, please provide reason
Any pets in particular you are not comfortable with
Applicant Declaration
Applicant Signature
Application Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty:

Employment Application and Personnel Profile

Application Consent and Position Details

Personal Details

Work Entitlement and Compliance

Emergency Contact and Driver Details

Availability and Current Employment

Education, Training, and Referees

Workplace Injury and Health Declarations

Industry Qualifications and Client/Participant Preferences

Applicant Declaration