EMPLOYMENT APPLICATION FORM
Which position are you applying for and what are your contact details?Position applied for/ Reference number: Community Mental Health Services Coordinator - Fremantle / Date:
Title: Mr.….. / Mrs.…. / Ms…. / Miss…/ Dr….Other….
Surname: / First Name:
Preferred Name: / Email Address:
Postal Address:
Home Phone: / Mobile Phone:
Roster Availability: N/A (Full-time) / Total number of hours: 38
Location preference/s: N/A
For a specific role – not to be used for generic applications
How did you hear about this position?Ruah Community Services Website / Seek Advertisement
Newspaper Advertisement / Social Media (LinkedIn/Facebook etc)
Ruah staff member / Other
Health and Wellness
Please provide details of any previous or current medical condition or restriction, physical or otherwise, which may affect your ability to perform the essential requirements of the job.
This must include any medical condition or restriction arising from a previous worker’ compensation claim. Failure to provide such information may jeopardise your rights to workers’ compensation if a pre-existing disability is aggravated at work (Section 79 of the Workers’ Compensation and Injury Management Act 1981).
Disclosure of a medical condition or restriction does not necessarily exclude an applicant from employment.
Do you have any pre-existing medical condition/ injuries/ claims relevant to the position you have applied for? YES / NO
If yes, please give details:
Are there any other matters which may affect your ability to perform the role, which we should be aware of? YES / NO
If yes, please give details:
National Police Certificate
All positions at Ruah Community Services require a National Police Certificate.
This must be dated within three months; must only be from the post office or through this link https://www.police.wa.gov.au/Police-Direct/National-Police-Certificates. Online versions like crimcheck or CV check are not accepted.
Do you have any convictions for any offences from any court; or are you currently the subject of any charge pending before any court?
[ ] Yes [ ] No if ‘Yes’, please give details including dates:
A criminal record does not necessarily disqualify an applicant for employment with Ruah. However an offence of a sexual nature, injury to another person, drug, fraud or other offence relevant to the duties of the position may render a person unsuitable for employment. If rejection of your application is considered solely because of a criminal record you will be given the opportunity to discuss the matter fully before a final decision is made.
RIGHT TO WORK IN AUSTRALIA
(Ruah needs to ensure that all staff have a legal entitlement to work in Australia. Answering the questions below will enable Ruah, to ensure we have the right legal documentation)
Are you Aboriginal or Torres Strait Islander? YES / NO
If you are Aboriginal or Torres Strait Islander, then you need to provide a statutory Declaration (Stat dec), or other documentation (birth certificate or passport)
If ‘NO’ please answer below.
Are you an Australian Citizen? YES / NO
(if yes, you will need to provide a birth certificate or passport)
Are you a New Zealand Citizen? YES / NO
(if yes, you will need to provide a birth certificate or passport)
If ‘NO’, to the above questions, do you have an appropriate Visa to work in Australia? YES / NO
Please give details of Visa or Permanent Residency:
Details to be shared with selection panel
What relevant experience, certificates and qualifications do you have? [Please address]Overseas qualifications must be checked by the Overseas Qualification Unit to determine their comparability with Australian standards. This is a free service and can be done here: http://www.migration.wa.gov.au/services/overseas-qualification-unit
How do you meet the Selection Criteria for the role?
Please address the selection criteria below with 1-2 paragaphs per answer. You must address all the questions to be considered for this role. Please note, this box will expand as you type.
Essential Skills [Please address]
· Willingness and ability to work within and contribute to the vision, mission, core values and the guiding principles of the organisation
· Relevant Tertiary Degree qualifications in Social Work/Psychology or similar and/or relevant work experience in the health or community service sectors.
· Ability to lead services teams and be an expert in a specialist service area.
· Strong interpersonal skills including conflict resolution and decision making.
· Demonstrated understanding of the context and issues facing people who experience complex, multi level, life debilitating circumstance. These may include but not limited to homelessness, AOD use, HIV, family/domestic violence and mental health issues.
· Demonstrated experience in the provision of supervision of staff and in building and managing positive teams.
· Demonstrated program management skills to plan and implement service program, coordinate work allocation, monitor and support case worker, respond to escalate incidents risks.
· Demonstrated ability to work within a case management model including boundaries and constraints to achieve positive client outcomes.
· Demonstrated ability to build relationships, liaise and advocate effectively with a range of community stakeholders to optimise service delivery.
· Excellent verbal and written communications skills including report writing.
· High level computer and administration skills to coordinate and verify client date collection, staff rosters and timesheets, organisation and Human Resource compliance at the team level.
· Knowledge and understanding of diversity, gender and social inclusion, particularly Aboriginal culture.
Program Specific
· Advanced skills and knowledge in mental health, biopsychosocial and psychosocial rehabilitation, mental health recovery and individualised person centred approaches.
Documentation [Please tick to confirm]
· National Police Certificate Yes No Date of Issue:
(Must be dated within three months; must only be from the post office or through this link https://www.police.wa.gov.au/Police-Direct/National-Police-Certificates. Online versions like crimcheck or CV check are not accepted).
· Evidence of the “Right to Work” in Australia (must provide evidence)
· Current motor vehicle driving licence Yes No Expiry Date:
· WA Working with Children’s Check Yes No Expiry Date:
Other requirements
· Access to a reliable and appropriate motor vehicle Yes No
EMPLOYMENT REFEREES
Please provide the names, addresses and telephone numbers of two persons as work related referees from whom confidential reports may be obtained. Referees will only be contacted following interview and with your permission.
Referee 1 Company
Position Phone number
Referee 2 Company
Position Phone number
Disclaimer and Signature
Your application form contains personal information, which will be dealt with in a confidential manner by Ruah Community Services strictly for the purposes of facilitating the recruitment and selection process. If you are successful in your application, your form will become part of your employment record. If you are unsuccessful your application form will be kept for 3 months before being destroyed.
Enquiries should be directed to HR via or 08 9485 3939.
· I understand that any misrepresentation of facts in this application could be cause for termination if employed.
· I consent to any reference checks which may be necessary to support this application.
· I hereby declare that the information contained in this application is to the best of my knowledge true and correct.
Applicant's Signature / Date
Applicant Checklist
This employment Application Form with selection criteria addressed / Resumé/CV
HR/Admin Checklist for Interview
National Police Certificate / Right to Work in Australia / Copy of Qualifications / Drivers Licence
WA Working With Children Check (if applicable) / Reliable & appropriate Motor Vehicle (if applicable)
Page 2 of 5