Disability Support Worker - Life Choices

The Flagstaff Group recruitment applications are hosted by external service providers who also recognise the importance of privacy. By proceeding with your application, you acknowledge that your personal information will be hosted by these external service providers until such time as you elect not to have your information stored on these external hosted sites.

1. Yes I agree to the privacy statement*

1. First name*
2. Last name*

1. E-mail*
2. Phone*

   Digits only or add + for international numbers

1. Street*
2. Street Cont.
3. City, Town or Suburb*
4. Postcode or Zipcode*
5. Country*Please choose... AFGHANISTAN ALBANIA ALGERIA AMERICAN SAMOA ANDORRA ANGOLA ANGUILLA ANTIGUA AND BARBUDA ARGENTINA ARMENIA ARUBA AUSTRALIA AUSTRIA AZERBAIJAN BAHAMAS BAHRAIN BANGLADESH BARBADOS BELARUS BELGIUM BELIZE BENIN BERMUDA BHUTAN BOLIVIA BOSNIA AND HERZEGOVINA BOTSWANA BRAZIL BRUNEI DARUSSALAM BULGARIA BURKINA FASO BURUNDI CAMBODIA CAMEROON CANADA CAPE VERDE CAYMAN ISLANDS CENTRAL AFRICAN REPUBLIC CHAD CHILE CHINA COLOMBIA COMOROS CONGO CONGO, THE DEMOCRATIC REPUBLIC OF THE COOK ISLANDS COSTA RICA COTE D'IVOIRE CROATIA CUBA CYPRUS CZECH REPUBLIC DENMARK DJIBOUTI DOMINICA DOMINICAN REPUBLIC ECUADOR EGYPT EL SALVADOR EQUATORIAL GUINEA ERITREA ESTONIA ETHIOPIA FALKLAND ISLANDS (MALVINAS) FAROE ISLANDS FIJI FINLAND FRANCE FRENCH GUIANA FRENCH POLYNESIA GABON GAMBIA GEORGIA GERMANY GHANA GIBRALTAR GREECE GREENLAND GRENADA GUADELOUPE GUAM GUATEMALA GUINEA GUINEA-BISSAU GUYANA HAITI HOLY SEE (VATICAN CITY STATE) HONDURAS HONG KONG HONG KONG SAR, CHINA HUNGARY ICELAND INDIA INDONESIA IRAN, ISLAMIC REPUBLIC OF IRAQ IRELAND ISRAEL ITALY JAMAICA JAPAN JORDAN KAZAKHSTAN KENYA KIRIBATI KOREA, DEMOCRATIC PEOPLE'S REPUBLIC OF KOREA, REPUBLIC OF KUWAIT KYRGYZSTAN LAO PEOPLE'S DEMOCRATIC REPUBLIC LATVIA LEBANON LESOTHO LIBERIA LIBYAN ARAB JAMAHIRIYA LIECHTENSTEIN LITHUANIA LUXEMBOURG MACAO MACAU SAR, CHINA MACEDONIA, THE FORMER YUGOSLAV REPUBLIC OF MADAGASCAR MALAWI MALAYSIA MALDIVES MALI MALTA MARSHALL ISLANDS MARTINIQUE MAURITANIA MAURITIUS MEXICO MICRONESIA, FEDERATED STATES OF MOLDOVA, REPUBLIC OF MONACO MONGOLIA MONTSERRAT MOROCCO MOZAMBIQUE MYANMAR NAMIBIA NAURU NEPAL NETHERLANDS NETHERLANDS ANTILLES NEW CALEDONIA NEW ZEALAND NICARAGUA NIGER NIGERIA NIUE NORFOLK ISLAND NORTHERN MARIANA ISLANDS NORWAY OMAN PAKISTAN PALAU PANAMA PAPUA NEW GUINEA PARAGUAY PERU PHILIPPINES PITCAIRN POLAND PORTUGAL PUERTO RICO QATAR REUNION ROMANIA RUSSIAN FEDERATION RWANDA SAINT HELENA SAINT KITTS AND NEVIS SAINT LUCIA SAINT PIERRE AND MIQUELON SAINT VINCENT AND THE GRENADINES SAMOA SAN MARINO SAO TOME AND PRINCIPE SAUDI ARABIA SENEGAL SEYCHELLES SIERRA LEONE SINGAPORE SLOVAKIA SLOVENIA SOLOMON ISLANDS SOMALIA SOUTH AFRICA SPAIN SRI LANKA SUDAN SURINAME SVALBARD AND JAN MAYEN SWAZILAND SWEDEN SWITZERLAND SYRIAN ARAB REPUBLIC TAIWAN, PROVINCE OF CHINA TAJIKISTAN TANZANIA, UNITED REPUBLIC OF THAILAND TOGO TOKELAU TONGA TRINIDAD AND TOBAGO TUNISIA TURKEY TURKMENISTAN TURKS AND CAICOS ISLANDS TUVALU UGANDA UKRAINE UNITED ARAB EMIRATES UNITED KINGDOM UNITED STATES URUGUAY UZBEKISTAN VANUATU VENEZUELA VIET NAM VIRGIN ISLANDS, BRITISH VIRGIN ISLANDS, U.S. WALLIS AND FUTUNA WESTERN SAHARA YEMEN ZAMBIA ZIMBABWE INTERNATIONAL OTHER Unknown
6. State, Region or Province*Please choose...

1. LinkedIn URL

   (Please click on your profile and copy the URL from your profile page.)

1. Privacy & Disclosure Acknowledgement Statement Privacy: All details provided on this form are treated confidentially. If appointed, the completed declaration form will be retained on your personnel file, which is kept secure at all times. Disclosure: This declaration may be disclosed at any time to an independent medical practitioner should the Group require an assessment of your suitability for employment and fitness for duty. This declaration may also be disclosed to the Group’s Workers Compensation insurer should a Workers Compensation claim arise in relation to you. The declaration, or partial details from it, may also be disclosed to any member of the Group's Board, Executive Management team or any Government Authority/Agency. Do you agree to the Privacy & Disclosure statement above? *

   1. Yes
   2. No
2. DIVERSITY: Do you identify as Aboriginal/or Torres Strait Islander? *

   1. Yes
   2. No
3. Was your first language in the home a language other than English? If yes, please identify.*
4. AUSTRALIAN CITIZENSHIP OR RESIDENCY STATUS: Are you currently authorised to work in Australia? *

   1. Yes - I'm a citizen
   2. Yes - I'm permanent resident
   3. Yes - I hold a current work visa (will need to provide if successful)
   4. Yes - I hold a current student visa (will need to provide if successful)
5. GENERAL: If you do not disclose accurate information this could affect offers of employment or the continuation of any subsequent contract of employment. Do you or have you ever worked for The Flagstaff Group before? *

   1. Yes
   2. No
6. Do you currently have any family members receiving services from The Flagstaff Group? If yes, please provide your family member's name and surname below. Otherwise, just write N/A.*
7. I understand if I am successful for any role at Flagstaff I may be required to provide, or be willing to obtain the following documents: 1. Cleared Employee Working with Children Check 2. NDIS Worker Screening Check 3. National Police Check 4. Valid Australian Driver's Licence 5. Vehicle Registration & Comprehensive Vehicle Insurance (not CTP Greenslip) (role specific) *

   1. Yes - I'm willing to obtain & provide copies
   2. No - I'm not willing to obtain or provide copies
8. If you hold a cleared Working with Children’s Check (WWCC), please provide the number below.*
9. If you have a NDIS Worker Screen Application Number please provide the number below.*
10. Do you hold a current First Aid Certificate with CPR?

    1. Yes
    2. No
    3. No - willing to obtain if required for the role
11. MEDICAL AND/OR HEALTH CONDITIONS: The Flagstaff Group is committed to the health and wellbeing of every employee and will employ safe working practises to minimise the risk of workplace injury to its employees. Failure to make a disclosure, or the making of a false or misleading disclosure, may result in termination of employment should you be successful in obtaining employment regardless of any length of employment at the time. Have you read and understood the Job Description for this role and/or any selection criteria?

    1. Yes
    2. No
12. Are you aware of; any pre-existing injuries, pre-existing illness, health conditions or circumstances which may affect your ability to carry out the full range of duties of the role? If yes please specify; *
13. If yes, are you currently undergoing or receiving any treatment?*
14. As a Flagstaff employee (role specific) you may be required to carry out extended periods of driving. Are there any reasons why you might not or would not be able to comply with these requirements? *