Mr. / Ms. / Mrs. / Miss. / Other ______
Family Name: ______
Given Names: ______
Date of Birth: ______/______/______Address: ______
Suburb: ______State: ______Postcode: ______
Phone: ( )______Mobile Phone: ( )______Email:______
Please indicate your preferred hours of work:
Full-time Part-Time Weekend/Shift Work Irregular/Intermittent (Casual)
Have you worked for AHL before? Yes No
If yes, which Hostel or Office?
Do you have a relative that works for Aboriginal Hostels Limited? Yes No
If yes, Please provide details:
Do you hold a current Working With Vulnerable People Registration? Yes No
Expiry Date ______/______/______(If successful in employment with AHL you will need to provide a copy)
Are you an Australian Citizen? Yes No
If successful in applying for a position at AHL you must be able to provide proof of Australian Citizenship.
CURRENT EMPLOYMENT DETAILS
Have you received a redundancy/retrenchment benefit from the APS or a Commonwealth Government agency in the last 12 months?
Yes No Date of Redundancy ______/______/______
Are you currently employed within the Australian Public Service? Yes No
If Yes, please provide details: ______
Department/Agency: ______AGS Number: ______Classification: ______
Ongoing/Permanent Non-Ongoing/Temporary Casual
REFEREE DETAILS – Please provide details of two referees (if possible, please include a current supervisor)
Referee One
Name of Referee:
Organisation
Referee’s Position
Relationship to Candidate
Contact Number
Email Address
Referee Two
Name of Referee:
Organisation
Referee’s Position
Relationship to Candidate
Contact Number
Email Address
WORKPLACE DIVERSITY DETAILS (Optional)
Please advise your Gender: Male Female Other
Are you of Aboriginal or Torres Strait Islander descent? Yes No
Do you identify yourself as a person with a disability? Yes No If necessary, please describe assistance required to attend an interview:
Is English your first spoken language? Yes No
Will you require an interpreter for your interview? Yes No
If an interpreter is required, please state the language:
Please select how you became aware of this vacancy:
APS Jobs Seek.com Ethical Jobs Koori Mail Facebook
Other: ______
IMPORTANT: DECLARATION OF CRIMINAL HISTORY - All candidates to be employed by AHL will be subject to pre-employment checks, including a National Police History Check. When answering these questions you are required to declare any convictions including driving related offences and/or any current matters pending before a court. General speeding or parking infringements that did not result in a summons to court are excluded.
Do you have any convictions, driving related offences or pending court outcomes which are less than 5 years old? If Yes, provide details below. / Yes No
Do you have any convictions, driving related offences or pending court outcomes which are over 5 years old, and/or where the sentence imposed was imprisonment? If Yes, provide details below. / Yes No
Are you currently the subject of/or applicant in any pending court matters? If Yes, provide details below. / Yes No
Have you ever been subjected to investigation under the APS Values and Code of Conduct? If Yes, provide details below. / Yes No
Details:
DECLARATION - In applying for a position(s) within AHL I hereby declare that:
As an Australian citizen I am eligible for non-ongoing or ongoing employment, and if successful can provide a valid passport and/or full birth certificate and photo identification to support my application. I consent to undergo pre-employment checks. If required, I agree to complete a Working with Children registration (or similar). I understand that the procedure and timeframe for obtaining certification is administered by the state or territory where the position is to be filled. I am aware that I must maintain my certification while employed by AHL.
I declare that the information provided by me in this application is complete and true. I understand giving false or misleading information in my application, including Section 8 Declaration of Criminal History, may be in breach of the APS Values and Code of Conduct, which may affect my employment with AHL.
Full Name(please print):______
Signature:______Date:______/______/______
(When submitting an application electronically only, a signature will not be required. You agree, that by choosing to submit your application electronically, you declare the above statements to be true.)
PART 3: STATEMENT OF CLAIMS – APPLICANT TO COMPLETE
In the space provided below, please provide a brief summary of your skills and experience relevant to the position. Please limit your response to one page (maximum of 800 words). Your response should take into account the duties, responsibilities, skills and experience required for the position (Pages 1 & 2).
All applicants will be assessed in relation to their ability to perform in accordance with the APS Values and Code of Conduct, the social justice principles of equity and workplace diversity, and occupational health and safety in the workplace.
Please submit a completed Application Form, including an up-to-date Resume to , by the closing date of 10 January 2018
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