Have you completed the NDIS Quality and Safeguards Commission eLearning? *

What are your requested minimum and maximum hours per week?

{html-8}
Name: {name-1}
Date of Birth: {text-8}
Address: {address-1-address_line} {address-1-street_address}, {address-1-city}, {address-1-state} {address-1-zip}
Phone: {text-6}
Email: {email-1}
Gender: {select-1}

Emergency Contact: {name-2}
Emergency Contact Phone: {text-7}

Resume (CV): {upload-2}

What was your last job? {text-1}
What date did it end? {text-2}
Do you have previous relevant experience? {radio-19}
{textarea-15}
What position/s are you interest in? {checkbox-3}
Please Confirm as you MUST have the following:
The following prerequisites are required. Please confirm that you meet all of them.
{checkbox-2}
{radio-21}
Are you an Australian Citizen? {checkbox-4}
Have you completed the NDIS Quality and Safeguards Commission eLearning?
{radio-22}
Are you willing to obtain the NDIS Quality and Safeguards Commission eLearning?
{radio-23}
Do you smoke?{radio-15}
What regular commitments do you have that we need to consider when rostering? Be specific, what days and times you are unavailable for work.
{textarea-13}
Do you have any bookings or commitments over the next 12 months that may impact your availability?  {radio-16}
What are they and when?
{textarea-14}
Are you willing to be called at short notice to cover shifts if other Employees are unavailable? {radio-17}
Are you willing to do one weekend per fortnight? {radio-18}
What are the requested hours per week? Min: {text-12} Max: {text-11}
What is your earliest date available to start work? {text-9}

Please list any languages other than English that you speak, including AUSLAN:
{textarea-17}
Do you give consent for Independence World to perform a Police Check on you at any time?
{radio-20}
Please list any past or present criminal charges:
{textarea-18}
Please list any present or intended civil or criminal proceedings:
{textarea-23}
All goals for the next 6 months to a year:
{textarea-19}
List major goals for the next 5 years:
{textarea-20}
What are your hobbies and interests?
{textarea-22}

Comments:
{textarea-21}