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Home
About Us
Referral Online
Our Services
Nursing Services
Garden Services
Transport Services
Personal Care Services
Cleaning Services
Shopping and Meals
Supported Independent Living (SIL)
Responsive Behaviour Management
NDIS
Contact Us
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Home
About Us
Referral Online
Our Services
Nursing Services
Garden Services
Transport Services
Personal Care Services
Cleaning Services
Shopping and Meals
Supported Independent Living (SIL)
Responsive Behaviour Management
NDIS
Contact Us
Menu
Home
About Us
Referral Online
Our Services
Nursing Services
Garden Services
Transport Services
Personal Care Services
Cleaning Services
Shopping and Meals
Supported Independent Living (SIL)
Responsive Behaviour Management
NDIS
Contact Us
Call +61 414 309 995
Recruitment Form
PERSONAL DETAILS
Title
First Name
Surname
Middle name(s)
Address
Postcode
Date of birth
Email
Tel mobile
Tel home
Sex
Male
Female
Other
UNIFORM
When working with Unique living options on a temporary basis, our Professionals are required to wear Uniformed Polo Shirt or Scrubs and ID Badges. We will therefore send through a Polo Shirt or Scrub, a Lanyard and an ID Badge to your home address ideally prior to commencing your first shift with us.
Size of Polo Shirt - Mens
X Small
Small
Medium
Large
Extra Large
2XL
3XL
5XL
Size of Polo Shirt - Female
6
8
10
12
14
16
18
20
22
24
Size of Scrubs - Male
XS
S
M
L
XL
Size of Scrubs - Female
XS
S
M
L
XL
Address for Uniform to be sent to:
EMERGENCY CONTACT 1
Name
Tel home
Relationship to you
Tel mobile
EQUAL OPPORTUNITIES
Unique living options Recruitment has an Equal Opportunities policy which is available upon request. For the sole purpose of monitoring our policy, please indicate your ethnic origin
SOURCE
Where did you hear about us?
Unique living options website
Job board
Exhibition
Referral
Search engine
Journal/Magazine
Other
Referral
If you chose Referral, please confirm who referred you:
EMPLOYMENT REQUIREMENTS
Profession / Job title
Grade / Years of experience
Do you have 6 months or more experience being medication competent?
Yes
No
Desired Locations for shifts (areas/suburbs)
Max. travelling time to employment
Can you drive and do you have access to a vehicle?
Yes
No
What date are you available to start working shifts
PROFESSIONAL REFERENCES
Please provide details for 3 referees that you have reported to whilst working in the position you are applying for. For example, for an AIN position we accept RN or above and for RN position we accept Supervisor/Manager referees. PLEASE NOTE: The referee must have worked with you in Australia.
Reference 1
Facility where you worked together
Referee Full Name
Referee Position
Referee Email
Referee Telephone
Reference 2
Facility where you worked together
Referee Full Name
Referee Position
Referee Email
Referee Telephone
Reference 3
Facility where you worked together
Referee Full Name
Referee Position
Referee Email
Referee Telephone
DISABILITIES
Do you have a disability under the terms of the Disabilities Discrimination Act?
Yes
No
OVERSEAS CRIMINAL RECORD DECLARATION
Since turning 16, have you been a citizen or permanent resident of a country other than Australia?
Yes
No
If Yes, have you ever been convicted of any assault in any other country? *
Yes
No
BANK DETAILS
Name of Bank or Building Society
Address of Bank or Building Society
Name of Account Holder
BSB
Account Number
TAX FILE NUMBER
Tax File Number (TFN)
Are you...
An Australian Resident for Tax Purposes
A Foreign Resident for Tax Purposes
A Working Holiday Maker
Do you want to claim the tax-free threshold from this payer?
Yes
No
Do you have a higher education loan program (HELP), student start-up loan (SSL) or trade support loan (TSL) debt?
Yes
No
Do you have a financial supplement debt?
Yes
No
SUPERANNUATION
I request that all my future superannuation contributions be paid to
My Employer’s Superannuation Fund (Australian Super)
My Own Choice of Superannuation Fund
Superannuation Fund Name
Superannuation Fund Membership ID Number
COVID-19 DECLARATION
Have you travelled interstate or overseas in the last 14 days?
Yes
No
If yes, please provide information.
Have you knowingly been in contact with anyone diagnosed with COVID-19?
Yes
No
Do you currently have any of the following symptoms? (Fever; Cough; Fatigue; Shortness of breath; Sore throat)
Yes
No
Have you worked at a facility that has had confirmed cases of COVID-19?
Yes
No
If so, please provide dates and important information related.
I acknowledge that at any time during my placement, if I develop any symptoms of Coronavirus, or become unwell I will immediately notify my superviser and Unique Living Options and leave the placement environment. *
I have received a copy of the Unique Living Options Recruitment Casual Terms of Employment. I have read and understood those terms and agree to be bound by them. *
I have engaged Unique Living Options Recruitment to act on my behalf to source employment and authorise my resume and details to be presented to their clients.*
I declare that the details given by me on this application form are correct to the best of my knowledge and belief. I understand that if I have given any information which is false, or I withhold any relevant information, this may lead to my application being rejected or if already appointed, to my dismissal. *
I have read and understood the Charter of Aged Care Rights, I understand and acknowledge the importance of these rights when working within Aged Care, Residential Care, Home Care or any other aged care service. I will ensure that I always abide by these rights. Link to the Charter of Aged Care rights if required: https://www.agedcarequality.gov.au/consumers/consumer-rights *
Print Name
Date
Send