NDIS Support Worker Application

Please fill in the Support Worker Application to the best of your ability. You will need your qualification and competency certificates/cards; insurance certificate; employment history; references; self-employment details; ID and police check.

This application should take approx. 20 mins.

PERSONAL INFORMATION

First Name *

Last Name *

Date of Birth *

Age as of Today *

Under 18

18 and over

Gender *

Female

Male

Prefer Not To Say

Email *

Mobile Phone Number *

Address *

City *

State *

Postal Code *

What is your Visa Status? *

Australian Citizen

Resident

Other

NEXT OF KIN (PERSON TO BE CONTACTED IN CASE OF AN EMERGENCY)

First Name - Next of Kin *

Last Name - Next of Kin *

Address - Next of Kin *

City - Next of Kin *

State - Next of Kin *

Postcode - Next of Kin *

Mobile Phone Number - Next of Kin *

Relationship - Next of Kin *

PROFESSIONAL QUALIFICATIONS

Please tick your Support Worker qualifications

Cert 4 Individual Disabiliyy Services

Cert 3 Individual Disability Services

None/other

Please Specify your Qualification/s

Are you Working Towards any Qualifications?

Please Upload all Relevant Documents Here (copies of certificates etc)

Upload Links to Qualifications

INSURANCE

Do you have Insurance?

Professional Liability Insurance

Comprehensive Car Insurance

Working towards Insurance

None/Other

Insurance Expiry Date

Upload Copy of Insurance/s

Upload Links to Insurance/s

Upload Car Insurance

PERSONAL STATEMENT

Please tell us why you want to work for Stones Disability Services AND why you think you fit the role and our organisation:

Write Below *

EMPLOYMENT HISTORY

Upload CV

Upload Link to CV

Current/Most Recent Role *

Role/Job Title
Organisation
Date From
Date To
Key Responsibilities
Reason for Leaving

Employment History - Free Fill

Please provide two referees. One should be your most recent employer if possible: (Please inform your referees that we will be calling.)

REFERENCES

Reference 1 *

Reference 2

SELF EMPLOYMENT DETAILS

Do you have an ABN (Australian Business Number)? *

Yes

No

Processing

ABN Number

Business/Self Employed Name

Business Address

Upload your Business Name Certificate

IDENTIFICATION

ID (100 points) *

Passport - Foreign - Current (50 points)
Passport - Australian - Current or Expired within 2 years but not cancelled (50 points)
Australian Citizen Certificate (50 points)
Australian Drivers Licence/Learners Permit (50 points)
Full Birth Certificate (50 points)
Medicare Card (25 points)
Property Lease Agreement for Current Address (25 points)
Utility Bill Showing Current Address (25 points)

Please Upload Copies of ID totalling 100 Points

Upload copies of ID *

POLICE CHECK

Have you completed a Police Check? *

Yes

No

Processing

Upload Police Check Certificate

Upload Link to Police Check

SIGN AND SUBMIT

By signing below, I certify all information contained within this application is correct to the best of my knowledge. I acknowledge that providing false information is grounds for refusing to hire me, or for termination should I be hired. *

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NDIS Support Worker Application

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