501(b) Advertised Vacancy Application Form

Strictly Confidential

It is the policy of OneCare to fill vacancies on the basis of merit. All appointments will therefore be based on the applicants’ ability to successfully meet the essential and inherent job requirements as detailed in the position description.

The application form is a source of information, which will be used by OneCare to assist us in considering your suitability for the position for which you are applying. Failure to supply the information requested may hinder OneCare’s ability to assess your suitability for the positon.

Given the nature of our business, OneCare wishes to advise all candidates that any offer of employment with OneCare is subject to the provision of a recent National Police Check and undertaking a pre employment health assessment.

Thank you for your interest in working with OneCare.

Advertised Vacancy
Job Title
Location
Employment Type
Where did you hear about this vacancy?
If your application is successful, when could you start?
Completed applications should be forwarded to: / Via email:
Personal Details
First Name(s):Surname:
Address:
Home Phone:Mobile:
Email:
Do you hold a current Driver’s Licence? ☐ Yes ☐ No
Drivers Licence type and number:
Are you an Australian Citizen/Permanent Resident? ☐ Yes ☐No
If no, do you have a working visa? ☐ Yes ☐No
Visa Type (please include all details with your application):
General
Do you have any family members living or working at a OneCare site?
☐ Yes ☐ No
Please provide details:
Can you think of any reason, including any medical issue, or previous workers compensation claim, which may affect your ability to perform the requirements of the position, including regular attendance at work?
☐ Yes ☐ No
Please provide details:
Do you have any other known condition which might affect you ability to safely perform the requirements of the position, including that may impact on the safety of employees or clients?
☐ Yes ☐ No
Please provide details:
Education & Qualifications
Please list any appropriate education, professional or trade qualifications that are relevant to the position you are applying for. Copies of your qualifications will be required before employment
Qualification / Institute / Year of Completion
Eg. Certificate III Aged Care / Work & Training / 2011
Would you consider completing a qualification? ☐ Yes ☐No
If ‘Yes’ what would you like to complete a qualification in?:
Professional Registrations
Please list any professional registrations you hold that are relevant to the position you are applying forCopies of these registrations will be required prior to employment.
Registration / Expiry Date / Registration Number
Eg. Registered Nurse / 30 June 2015 / NWM0000031
Employment Details
What is your current employment status:
☐ Employed ☐ Self Employed ☐ Unemployed
Have you previously worked for OneCare?
☐ Yes ☐ No
Please provide location and dates:
Have you been the subject of disciplinary action or been dismissed by a previous employer?
☐ Yes ☐ No
Please provide location and dates:
Employment History
P llease complete your most recent employment history in the table below, starting with you current or most recent position
Employer / Position Held / Start Date / End Date / Reason for leaving
Referees
Please provide the details of current or most recent supervisors who have agreed to be referees and who can be contacted. If you have not worked before, teaching staff or volunteer supervisorsmay be considered. By completing this section, you are giving permission for OneCare to contact your nominated referees to provide information relevant to your application
Name / Company / Positon / Contact Details / Was this person a direct supervisor?
☐ Yes ☐ No
☐ Yes ☐ No
☐ Yes ☐ No
Criminal Clearance
Employment with OneCare is subject to the provision of a satisfactory National Police Check as required under the Aged Care Act 1997.
A criminal record does not necessarily disqualify an applicant. If rejection of your application is considered solely because of a criminal record, you will be given the opportunity to discuss the matter fully and confidentially with a senior member of staff before a decision is made.
Do you have any convictions for any offences from any court?
☐ Yes ☐ No
Please provide details:
Do you have any charges pending before any court?
☐ Yes ☐ No
Please provide details:
Are you prepared to produce a current National Police Check prior to accepting an offer of employment with OneCare
☐ Yes ☐ No
If a National Police Check was conducted today, would there be any new offences/charges on there?
☐ Yes ☐ No
If yes, please provide details:
Declaration
I declare that the statements I have made and the information I have given are true to the best of my knowledge and belief. I have not withheld any relevant information required by this application, or made any false or misleading representations.
I acknowledge that if I have knowingly or wilfully given false or misleading information or have withheld any information, it could result in:
  • Rejection of my application;
  • Legal proceedings against me; or
  • Dismissal after my appointment.

Applicant Signature: Date: