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Step 1 of 3 - Applicant Information

Applicant Information
Position Applied For*
Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Date of Birth*
DD slash MM slash YYYY
Email*
Home Phone Number*
Mobile Number*
Driver's License No.*
Country of Birth*
Are you an Australian/New Zealand Citizen/Permanent Resident?*
- Yes
- No
Eligible Work Visa*
- Yes
- No
Visa Details*

Emergency Contact Details
Emergency Contact Name*
Relationship*
Home Phone*
Mobile*
Work*

Employment Information
Please note this legislation before you answer the next 2 questions. As per Section 571B & 571C of the Workers’ Compensation and Rehabilitation Act 2003, a prospective worker must disclose to the prospective employer the prospective worker’s pre-existing injury or medical condition, if any. If the prospective worker knowingly makes a false or misleading disclosure, the prospective worker or any other claimant will not be entitled to compensation or to seek damages for any event that aggravates the pre-existing injury or medical condition.
Have you ever had a Workcover Claim?*
- Yes
- No
Please Provide Details*
Do you have any disability, medical condition, allergies or injuries that would affect your ability to perform your expected duties if employed by NoosaCare Inc?*
- Yes
- No
Please Provide Details*
Qualifications/Abilities (i.e. languages), First Aid Certificate, Placement etc.*
Which days/times are you available to work?*
Please Upload Scanned Resume*
Max. file size: 10 MB.
Policy*
*
I declare:
- That the answers to the forgoing questions are, to the best of my knowledge, true and correct;
- That I have the right to Work in Australia and have the appropriate documentation to verify it, if
requested by NoosaCare Inc.
- That I understand any false declaration made by me in this application subjects me to dismissal; and
- I accept that there will be a probationary period, to be discussed at the commencement of employment, and that notice given during this period will be as per the award.

I authorise NoosaCare Inc. to:
- Undertake my nominated personal or work references on my behalf, which will include information that directly relates to my skills, performance, conduct, and terms of employment.
- Undertake other pre-employment checks, including but not limited to, my right to work in Australia (through the Department of Immigration and Border Protection), Industry Body Registration, Medical, Functional capacity and work based testing (including personality profiling and
psychometric testing).

I acknowledge that:
- If I supply false or misleading information during any stage of NoosaCare Inc. employment process, I will be susceptible to the automatic withdrawal of my application and consideration of employment at NoosaCare Inc. or where employed up to and including termination of employment at NoosaCare Inc.
Verification

Step 1 of 3 - Applicant Information

Applicant Information

Emergency Contact Details

Employment Information

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