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    Applicant Details:

    Contact Details:

    Are you an Australian Citizen / Permanent Resident?*

    How long have you been in Australia?*

    Issue Date *

    Expiry Date *

    Do you consent for Lifecare to check your visa status on Vevo? *

    (Note: To be eligible for employment, applicants must have the appropriate work visa or have permanent residency status. A copy of a current work visa is required)

    Do you require any special arrangements at an interview? If yes, please give us a call. *

    Have you ever been in serious breach of any client protection and/or Code of conduct? *

    Do you have any convictions, finding of guilt and/or pending police charges against you relating to the abuse of, or inappropriate behavior towards a child, elderly or vulnerable person? *

    (Note: A criminal records check is a prerequisite of the position.)

    Referees Details:
    (NOTE : THREE REFEREES ARE REQUIRED. AT LEAST TWO OF THESE REFEREES SHOULD HAVE BEEN YOUR IMMEDIATE SUPERVISOR IN YOUR PAST OR EXISTING ROLE)
    1.Referee:

     

    2.Referee:

    3.Referee:

    Medical History

    Do you have any convictions, finding of guilt and/or pending police charges against you relating to the abuse of, or inappropriate behavior towards a child, elderly or vulnerable person? *

    Do you suffer from any allergies? *

    Are your immunizations for whooping cough, measles, chicken pox, tetanus and other transferable or infectious illnesses up to date? *

    Have you suffered from any infectious diseases in the past 12 months? *

    CERTIFICATION
    I hereby certify that the above information is correct and complete to the best of my knowledge and belief. I understand that, if I am employed, I will be liable to dismissal if any of the statements in my application are found to be deliberately misleading.

    Date*

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