Employment Application


    Do you have any medical condition, injury or disability that may affect your ability to safely perform the requirements of this role?

    This role may involve assisting clients with mobility and performing some manual handling tasks. Are you able to safely perform these tasks with or without reasonable adjustments?

    Are you taking any medication or treatment that may affect your ability to safely perform the duties of this role?

    Do you have any allergies we should be aware of to ensure a safe working environment?

    Are you pet friendly?

    Do you smoke?

    What is the highest level of Education / Qualification you have attained? (Certified copies of qualifications may be requested at interview)

    Most recent employment history

    References
    Name

    Contact Number:

    Name

    Contact Number:

    Name

    Contact Number:

    Do you hold a current Senior First Aid Certificate?

    De you have a current Police Clearance Certificate?

    What is your current COVID Vaccination status

    Do you consent to a pre-employment fitness assessment by a GP/Exercise Physiologist at our Expense?

    PLEASE BE AWARE OF SECTION 79 WORKERS COMPENSATION BOARD AND ASSISTANCE ACT 1981.
    “79. Where it is proved that the worker has, at the time of seeking or entering employment in respect of which he claims compensation for a disability, will fully and falsely represented himself/herself as not having previously suffered from the disability, Return to Work may in its discretion refuse to award compensation which otherwise would be payable.”