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PERSONAL DETAILS

* First Name

Middle Name

* Last Name

* DOB

* Home Address

* City

* State

* Postal Code

* Country

* Email

* Mobile

Current CV

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AHPRA Nursing Registration Number (applicable to registered nurses only)

Professional Reference 1

1. Reference Name

1. Company

1. Contact number

1. Email

Professional Reference 2

2. Reference Name

2. Company

2. Contact number

2. Email

Identity Documents

Please upload at least 3 forms of Valid Identification (100 Points) for a full list of accepted ID please refer to this link https://www.afp.gov.au/sites/default/files/PDF/NPC-100PointChecklist-18042019.pdf

Passport (Aus/NZ)

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Passport (International)

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Drivers Licence (Aus)

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Drivers License (Intl)

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Birth Certificate

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Proof of Age Card

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Medicare Card

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Utility Bill

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I.D - Other

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Current Australian Work Rights

* What are your current work rights in Australia?

If you are a current VISA holder, please attach a copy of your current working rights and IMMI grant notification.

IMMI Grant Notification

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Criminal Record Checks

* Have you been found guilty of any criminal offence or do you have any current criminal matters pending in Australia or Overseas?

If yes, please specify:

Do you hold a recent Police Check (Last 3 years)?

Police Check

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Qualifications

We are required to hold a copy of your primary qualifications, relevant to your role. If you hold them on file, please upload any relevant documents here:

Bachelor's Degree

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Diploma

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Certificate III

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Certificate IV

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As an aged care support worker you may be required to have completed a First Aid & CPR course within the last 3 years. If you hold them on file, please upload any relevant documents here:

First Aid and CPR Certificate

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First Aid Certificate (Standalone)

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CPR Certificate (Standalone)

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Worker Screening & Immunisations

If you do hold a current NDIS Worker Screening Check could you please upload it here, if not we will assist you with making an application:

NDIS Worker Screening Check

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It is the requirement for most of our providers that you have had 3 COVID Immunisations and an Influenza Immunisation within the last 12 months. If you hold them on file, please upload any relevant documents here:

COVID Immunisation

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Influenza

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ID Photo & Emergency Contacts

Dash Group will supply you with an ID Badge and Scrubs when you commence employment with us. Please upload a clear identity photo, which can be taken with a smartphone and shows your head and shoulders. You will also need to indicate your preferred size of scrubs:

ID Badge Photo

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* Scrubs Size

We are also required to hold an emergency contact on file:

* Emergency Contact Name

* Relationship to you

* Emergency Contact Phone Number:

* Do you suffer from any allergies that we should be aware of?

If yes, please specify here:

* Which of our healthcare teams are you joining?

* Which of our Consultants ran your screening?

Declaration

I hereby declare all information supplied to be true and correct to the best of my knowledge. I understand that if I have given false or misleading information that I may be liable and dismissed without notice. OH&S – Site/Facility Requirements If engaged by Dash Group, I agree to wear all relevant PPE (personal protective equipment) and/or clothing as required by dash group or its clients in accordance with statutory requirements (especially during Covid-19) and or the site / facility specific company policies. IF I FEEL THAT THE ACTIVITIES IN THE AGED CARE FACILITY ARE DANGEROUS OR PUTS ANYONES WELL BEING AT RISK, I WILL COMMUNICATE THIS WITH THE FACILITY MANAGER AND MY DASH CONSULTANT. If engaged by Dash Group, I agree to act in accordance with statutory requirements including the below companies’ policies. Whilst registering with Dash Group, I have read and noted the current policies: Fair Work information statement (embedded the following link on the title) https://www.fairwork.gov.au/employee-entitlements/national-employment-standards/fair-work-information-statement Dash Privacy Statement https://www.dashgroup.net.au/privacy-policy/

* I accept the above