Employee Application Form – Fair Haven Retirement Village

Skip to content

Home
About Us
Support Us
Links
Contact Us
Members
Visiting Fair Haven

FAIR HAVEN EMPLOYMENT APPLICATION:

Phone

PERSONAL DETAILS:

First Name *

Middle Name

Surname *

Date of Birth *

Contact Number *

Email Address *

Address *

Suburb *

Postcode

Current Member of the Free Reformed Church of *

POSITION DETAILS:

Position Sought *

Suggested Commencement Date *

Employment Type *

Casual Part Time

Number of Shifts available per week *

EDUCATION DETAILS:

Highest Level of Education/Qualifications *

University Tafe Secondary School

Certificate/Diploma obtained:

Institution Name: *

Year *

Upload copy of Certificate *

Other Education/Qualifications:

EMPLOYMENT HISTORY:

Previously Employed by:

Position Held:

Period of time worked in this position:

Reason for Leaving

Will this be verified by your Manager?

Other Employment/Experience:

REFERENCES:

Name: (Referral 1) *

Contact Number: (Referral 1) *

Written Reference:

Name: (Referral 2) *

Contact Number: (Referral 2) *

Written Reference:

ADDITIONAL INFORMATION REQUESTED:

Do you hold a current Senior First Aid Certificate? *

Yes No

Do you have a National Police Certificate less than 3 months old? *

Yes No

Do you have a Manual Handling Certificate?a National Police Certificate less than 12 months old? *

Yes No

Are you aware of/have any knowledge of pre-existing medical contidion or injury which mich act as an impediment to your performance in this position sought, either now or later in your employment? *

Yes No

Do you agree to a pre-medical appointment by a GP if requested? *

Yes No

PLEASE BE AWARE OF SECTION 79 WORKERS COMPENSATION BOARD AND ASSISTANCE ACT 1981:

79. Where it is proved that the worker has, at the time of seeking or entering employment in respect of which he claims compensation for a disability, will fully and falsely represented himself/herself as not having previously suffered from the disability, the Board may in its discretion refuse to award compensation which otherwise would be payable.

Section 79 acknowledgement:

I acknowledge completely that the deliberate giving of false information, with respect to any of the above areas, shall lead to dismissal.

Upload Resume here:

Declaration:

I hereby declare that the information provided is true and correct. I also understand that any willful dishonesty may render for refusal of this application or immediate termination of employment.

Date:

Pages

Home
About Us
Membership
Contact Us

Location

Fair Haven Retirement Village
15 Pine Tree Close
ARMADALE WA 6112

(08) 9399 7173

Links

Australian Free Reformed Churches
My Aged Care

Member Login

Username or Email

Password

Forgot? Register