APPLICATION FOR EMPLOYMENT

AVAILABILITY TO WORK

PERSONAL INFORMATION

(Required for entitlements and ID Checks)

ADDITIONAL INFORMATION

1. Why have you applied for the role ?*

2. Are you up to date with your Flu Vaccination or are you willing to obtain one ?*

YesNoWilling to obtain

3. What is your pay expectation ?*

4. Please list the languages that you speak in the box below:*

Occasionally we have residents that speak a variety of languages, and it is helpful to know which languages our employees can speak, as they may be able to provide support to our residents.

5. Do you have any pre-existing injury or disease which you are aware of or foresee, that could be affected by the nature of the duties and responsibilities of the position for which you are applying for?*

Disclosure of a medical condition or restriction does not necessarily exclude an applicant from employment.

This information will be used solely to assess your capability to safely perform the inherent requirements of the role and to consider any reasonable adjustments that may be required.

YesNo

6.Have you worked for our organisation previously?*

YesNo

If yes, position held and period of employment:
*

Values Based Questions

Please can you answer the following questions. The answers to your questions will be reviewed and assessed in accordance with our organisational values.

1. Value: Quality

A family is being shown around the facility, you have had a stressful day and a person has phoned in
sick in your team. The family are keen to know what it’s like to work at Dale Cottages would you?*

a) Tell them how much you are understaffed and how you are struggling today with your workload.b) Tell them how much you enjoy working for Dale Cottages and how you enjoy working in this environment.

2. Value: Care

You find a resident on the floor – what would you do?*

a) Help the resident back onto the chair or bed and quickly get on with your tasks. Falls happen and we can’t prevent them.b) Stay calm and help the resident and gather as many facts as possible after the incident and communicate this to the Nurse.

3. Value: Community

Your team has been super busy, and you are meant to have a team meeting once a week. You have noticed that your manager seems distracted with other priorities and your team are confused about what work they should be undertaking as a priority, would you,*

a) Ask your manager to arrange the next team meeting as soon as possible explaining that the team needs guidance.b) Wait for your manager to arrange a meeting and not say anything.

4. Value: Openness

How do you describe yourself at work?*

a) You love learning new things and are curious about new concepts and like to get feedback.b) You like set routines, don’t like change, and you don’t seek feedback

DECLARATION

I understand that I may be required to complete a Statutory Declaration if my application is progressed stating that I have no criminal convictions in any other country or territory.

I certify that the information in this application form is correct and complete to the best of my knowledge and belief.

I understand that Dale Cottages Inc. reserves the right to verify all information on this application (as well as details contained in my Resume) and I am fully aware that if I fail to disclose any relevant matter relating to my application and health, which rendered me incapable of fulfilling the duties of the position, the employer may not employ me and if already employed by the employer, my employment may be terminated.

Your signature below indicates your written permission for Dale Cottages Inc. to contact educational organisations, and government agencies (if required) to verify the information you have provided. Please indicate below if you object to this occurring.

Signature:*

Date:

YOUR APPLICATION

Reminder: your application will be considered by completing the above form as well as attaching your Resume.