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Application for Employment

"*" indicates required fields

MEDICAL

Do you have, or have you had, any injury, accident or medical conditions caused by gradual process, disease or infection – eg hearing loss, sensitivity to chemicals or latex, occupational overuse syndrome (OOS), back injury or strain, asthma, stress related conditions – which might be aggravated by or further contributed to by the tasks of this position, and/or prevent or affect your ability to carry out the functions and responsibilities of the position applied for?*
Do you have any other known condition which might affect your ability to safely perform the inherent requirements of the position, including that which may impact on the safety of employees or customers?*

DECLARATION

Declaration 1*
Declaration 2*
Declaration 3*

This information is collected for the purpose of assessing your suitability for employment with Carinya Care Services. This information is confidential and should be completed by the candidate only.

PERSONAL CONTACT DETAILS

Name*

EMERGENCY CONTACT DETAILS

EMPLOYMENT HISTORY

You may leave this section blank if all relevant information is adequately covered in your CV.

Present Or Most Recent Employer

Next Most Recent Employer

REFEREES

Please provide at least two previous managers with one being from your most recent job role. We will contact referees if you have been short listed.

EMPLOYMENT

If you are successful, will Carinya Care Services be your sole employer?*
If Carinya Care Services are not your sole employer at any time during your employment with Carinya Care Services, you are required as part of your contract of employment to notify your SDO of whom your other employer is, how many hours on average per week you work with them and in what role.

AVAILABILITY TO WORK

Please check the shifts that you are available. Please note that morning and evening shifts have staggered start times - please tick any that you are available to work.

This information MUST be an accurate reflection of your ongoing availability.

06:30 Shift
07:00 Shift
15:00 Shift
16:00 Shift
22:00 - 07:30 Shift
Total Number of shifts per week you are prepared to commit to:*
We DO NOT employ for less than 3 shifts per week.

RELATIONSHIPS WITH CARINYA CARE

LANGUAGES

Max. file size: 256 MB.
Max. file size: 256 MB.

NATIONAL POLICE CHECK

Can you provide a National/Federal Police Check that is no older than 6 months from the date of issue? If your interview is successful you will be required to provide a Police Check that is no older than 6 months before you can commence.*
Max. file size: 256 MB.

VACCINATION REQUIREMENTS

Can you provide evidence of full COVID-19 vaccination and current influenza vaccination? If your interview is successful you will be required to provide evidence before you can commence.*
Max. file size: 256 MB.

LEGAL WORK STATUS

If you are a holder of a Work Permit or Visa, please provide a copy and advise the expiry date.

Max. file size: 256 MB.

QUALIFICATIONS (including university, further education, etc, where applicable)

You may leave this section blank if all relevant information is adequately covered in your CV.
This field is for validation purposes and should be left unchanged.

USEFUL LINKS

CARINYA CARE CONTACT

Carinya of Bicton

220 Preston Point Road

BICTON WA 6157 

Carinya on Bristol

41 Bristol Avenue

BICTON WA 6157   

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LOCATIONS

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Carinya Care Services