Application Form

Step 1 of 4

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Date of Application(Required)

DD slash MM slash YYYY

Availability to Commence(Required)

DD slash MM slash YYYY

Type of Position

Personal Information

First Name(Required)

Surname(Required)

Preferred Name

Mobile(Required)

Home Phone

Email(Required)

Address(Required)

Street Address Address Line 2 City State Postcode

Gender(Required)

Date of Birth(Required)

Specify Gender

Are you an Australian Citizen?(Required)

Yes

If No, Please Specify Visa Type

Expiry

DD slash MM slash YYYY

Have you been a resident of a country other than Australia after the age of 16?(Required)

Yes

Languages Spoken

Training History

Course Name

Location

Year Completed

Other Training Details

Have you completed manual handling training?(Required)

Yes

Details

Professional References

Contact Name

Company Name

Position Held

Phone Number

When are you available? (please enter the times you will be available for work ie 6am-5pm)

Early Mornings

Mon

Tues

Wed

Thu

Fri

Sat

Sun

Before Midday

Mon

Tues

Wed

Thu

Fri

Sat

Sun

Afternoons

Mon

Tues

Wed

Thu

Fri

Sat

Sun

Evenings

Mon

Tues

Wed

Thu

Fri

Sat

Sun

Late Night

Mon

Tues

Wed

Thu

Fri

Sat

Sun

School Holidays(Required)

Yes

Public Holidays(Required)

Yes

Overnights(Required)

Yes

Getting around:

What type of Licence do you hold?(Required)

Unrestricted

Green P's

Red P's

Do you have the use of reliable, registered vehicle?(Required)

Yes

Does your vehicle have air-conditioning?(Required)

Yes

Are you happy to transport clients in your car?(Required)

Yes

Vehicle Body Type(Required)

Sedan

Hatch

4WD

Other

Insurance Type(Required)

Comprehensive

3rd Party Property

Greenslip Only

Standard care: Home care where there is no behaviour problems and where the client is able to weight bear and requires minimal assistance for toileting, showering and dressing.

Complex care: Home care involving behavioural problems that are difficult to manage or where the client has more physically complex needs. Includes personal care of a complex nature and palliative care.

Basic Skills

Housework

Meal Preparation

Shopping

Client Transport

Skills Requiring Some Experience

Standard Respite Care

Standard Personal Care

Dementia Care

Standard Overnight Care

Sign Language

Experience and documented evidence required

Complex Respite Care

Complex Personal Care

Challenging Behaviours

Complex Overnight Care

Bowel Care

Palliative Care

Hoist / Pelican Belt

Catheter Care

Tube / Peg Feeding

Employment History: (list current / most recent position first)

Position Held(Required)

Company Name(Required)

Employed From Date(Required)

DD slash MM slash YYYY

Employed To Date(Required)

DD slash MM slash YYYY

Company Address(Required)

Name of Supervisor(Required)

Supervisor Phone(Required)

May we contact your supervisor?(Required)

Yes

Reason for leaving(Required)

Your duties and responsibilities(Required)

Position Held

Company Name

Employed From Date

DD slash MM slash YYYY

Employed To Date

DD slash MM slash YYYY

Company Address

Name of Supervisor

Supervisor Phone

May we contact your supervisor?

Yes

Reason for leaving

Your duties and responsibilities

Position Held

Company Name

Employed From Date

DD slash MM slash YYYY

Employed To Date

DD slash MM slash YYYY

Company Address

Name of supervisor

Supervisor Phone

May we contact your supervisor?

Yes

Reason for leaving

Your duties and responsibilities

DO YOU HAVE ANY OTHER EXPERIENCE AS A CARER? (for example, as an informal carer for a family member / friend)

Privacy

Our HR Team screen all potential workers by completing the following;

assessment of your criminal record check (that must be provided to us, by you, at your cost)
assessment of your working with children check (that must be provide to us, by you, if you wish to work with children in your role)
assessing outcomes of reference checks

Consent(Required)

I hereby confirm that all information given by me in this application for employment is true and correct and I have not knowingly withheld any circumstances or facts that would, if disclosed affect my application. I understand that information contained in this form (other than information provided in my pre-employment medical questionnaire) shall be available only to employees and managers of Wendy’s Home Care who have direct involvement in the recruiting process. I understand that information contained in the Pre-Employment Questionnaire is treated as a confidential and access is limited to a ‘need to know’ basis. In the event of you being employed, Wendy’s Home Care will retain this information on a confidential file and reserve the right to refer to the information in the event of an accident, sickness, injury or claim for workers’ compensation. This information may also be used for other purposes if required by law.

Date

DD slash MM slash YYYY

For more information please call us on (02) 4587 5999 or visit our website www.wendyshome.com.au

Thank you for your interest in working at Wendy’s Home Care.

Personal Information

When are you available? (please enter the times you will be available for work ie 6am-5pm)

Getting around:

Employment History: (list current / most recent position first)

Privacy

Get in touch with our friendly staff