HUMAN RESOURCES
Application for Employment Form
PLEASE PRINT ALL INFORMATION REQUESTED AND COMPLETE ALL SECTIONS
A CURRENT RESUME OR CURRICULUM VITAE MUST BE ATTACHED IF NOT ALREADY SUBMITTED
Name:Dhaliwal ..............RajwantKaur Date:06/04/1990
Middle
Last
First
Middle
Street Address:.18, Delias road.
Suburb/TownTarneit....StateVictoria.Postcode3029
Telephone 0449716878 Mobile:0449716878
Emailrajwant_35@[Link]
Days/hours available to work (morning / afternoon / nights)
Monday
No Preference
.
Wednesday
Tuesday
Advertised:.
Friday
Thursday
e.g. The Age, Internet, Employment Agency
Saturday
Sunday
Date advertised: ..
Position applied for:PCA..
Employment desired: FULL-TIME ONLY PART-TIME ONLY FULL OR PART-TIME CASUAL
When are you available to commence work?as soon as possible.
Do you have a preference for which facility / site you wish to work?
Yes
No
If yes please specify:
.
HAVE YOU PREVIOUSLY BEEN EMPLOYED BY DOUTTA GALLA? Yes
No
If yes please specify when & at which site or facility:...
ARE YOU AWARE OF THE REQUIREMENT TO UNDERTAKE A CRIMINAL HISTORY RECORDS CHECK TO BE
ELIGIBLE TO WORK IN AGED CARE?
Yes No
HAVE YOU ALREADY SUBMITTED YOUR RESUME FOR THIS APPLICATION?
If yes please specify where/ to whom:
Yes
No
HAVE YOU AT ANY TIME SINCE TURNING 16 YEARS OF AGE BEEN A CITIZEN OR PERMANENT RESIDENT
OF A COUNTRY OTHER THAN AUSTRALIA?
Yes No
ARE YOU CURRENTLY ON A VISA?
Yes
No
PLEASE INDICATE THE TYPE OF VISA?
Student
Spousal
Bridging
Permanent Other _____________
(PLEASE SPECIFY)
DO YOU HAVE THE RIGHT TO WORK IN AUSTRALIA?
Yes
No
ARE THERE RESTRICTIONS ON YOUR VISA?
Yes
No
If you ticked Yes please specify any restrictions that apply: 20 hrs per week
.
Date of Issue
Oct 2013
Section
HR 1.0
Document No.
HR C1-S1.0-F1
Revision No.
1
Page no.
Page 1 of 2
HUMAN RESOURCES
DO YOU HAVE A CURRENT DRIVERS LICENCE? Yes No
What vehicles are you licensed to drive? Car.
Drivers licence number: State of issue:Punjab(India)... Expiration date:.//.
PLEASE ADD ANY ADDITIONAL INFORMATION THAT IS RELEVANT TO YOUR APPLICATION
.
Did you complete this application Yes No
If not, who did?
DECLARATION - PLEASE READ CAREFULLY
In exchange for the consideration of my job application by Doutta Galla Aged Services I acknowledge that:
I have provided all requested information and responded to all questions.
All details I have provided in this application and the accompanying (submitted) resume / curriculum vitae are
true and correct.
I understand that initial and ongoing employment with Doutta Galla Aged Services is subject to my consent
to authorize Doutta Galla to undertake a Criminal History Records Check
I understand that my application for employment and/or continuation of employment may be terminated in
the event that I am determined to not be eligible to work in Aged Care Services as a result of disclosable
offences arising from any Criminal History Records Check
I understand that initial and/or ongoing employment with Doutta Galla Aged Services may require a PreEmployment Medical Examination be undertaken to ensure I can undertake the inherent requirements of the
position(s) for which I have applied..
I accept and agree that Doutta Galla Aged Services Ltd has a drug and alcohol policy and my compliance
with such policy is a condition of my employment and/or continuation of employment.
I accept and agree that Doutta Galla Aged Services Ltd has an Employee Code of Conduct & Practice and
my compliance with the behavioural standards outlined in therein is a condition of my employment and/or
continuation of employment.
I accept and agree that Doutta Galla Aged Services Ltd has a privacy and confidentiality policy and my
compliance with such policy is a condition of my employment and/or continuation of employment.
I accept and agree that employment with Doutta Galla Aged Services Ltd shall be subject to both a
probationary and qualifying period.
Signature of applicant:Rajwant [Link]/07/2015
Doutta Galla Aged Services is an equal employment opportunity employer. We adhere to a policy of making employment decisions in accordance with the Equal
Opportunity Act 1995. Thank you for completing this application form and for your interest in our organisation.
Please return this application to:
Human Resources Manager
Doutta Galla Aged Services Ltd.
75 Moreland Street, Footscray 3011
Date of Issue
Oct 2013
Section
HR 1.0
Document No.
HR C1-S1.0-F1
Revision No.
1
Page no.
Page 2 of 2
