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First Name: *

Last Name: *

E-Mail Address: *

Address *

Contact Number *

Are you female or male? *

Female
Male

Do you have a driver's license? *

Yes
No

How old are you? *

Younger than 20
20 - 30
30 - 40
40 - 50
50+

What interests you in this position? *

What experience do you have? (Experience is not essential)

Please indicate when you are available for support worker shifts: *

Sleepovers + shift before and after: 9.30pm - 10.00am
Evening shift: 9.30pm - 10.30pm
Sleepover shift: 10.30pm - 6.00am
Day shift: 6.00am - 10.00am
Day shift: 11.30am - 1.00pm
Day shift: 5.00pm - 6.00pm

Any extra comments regarding availability?

Are you available to work weekends? *

Yes
No

Do you have a Disability Services Positive Notice Card? *

Yes
No
No - but willing to obtain

When are you able to commence? *

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Please attach your CV *

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