Please contact us for information on services in your area.
Name
DOB
Gender - select - Male Female
Address 1
Address 2
Town
State
Postcode
Phone
Mobile
Email
Emergency Contact
Do you have a car? Yes No
Do you have a current Australian Drivers Licence? Yes No
Have you completed any Certificates or Diplomas in ANY industry? Yes No
If yes, please state.
Or, are you applying for a Traineeship? Yes No
Provide relevant experience.
List qualities you have that would benefit your clients and or employer.
How many hours per week?(Trainees are required to work a minimum of 15 hrs per week+ some weekends) Hours
How many days days week? Days
Times available to work
Area and/or distance willing to travel
Are you available to work school holidays? Yes No
Are you available to work in Residential or Community Care or both? Yes No
Are you available to work between 7.00am and 8.00am? Yes No
Are you available to work between 3.30pm and 4.30pm? Yes No
Are you available to work between 4.30pm and 6.00pm? Yes No
Are you available to work between 6.00pm and 10.00pm? Yes No
Are you available to work weekends?(Weekend work is usually rotated) Yes No
Are you available to fill shifts at short notice? Yes No Comments:
Are you available for sleepovers 10pm - 7am? Yes No
Do you speak another language other than English? Yes No Please State:
Do you have any injuries or illnesses that My Health Carers should be aware of? Yes No Comments:
Referee 1
Referee 2
Please attach your current resume.