Employment Application Form

Nursing Home where applying  
Position applied for  
Date  

I found out about the position through:

 

  Newspaper Advertisment (please specify)  
  Online Advertisment (please specify)  
  Thompson Health Care Website  
  Staff Member  
  Other (please specify)  

Personal Details

  

Family Name  
Given Names  
Date of Birth  
Sex     Male       Female
Address  
Postcode  
Email Address  
Home Phone  
Mobile  
Languages spoken  
Are you an Australian resident?     Yes       No
If No, do you have a current work permit?     Yes       No

Qualifications


Current Registration number(s)  
Hours of Experience  

Employment History


Have you been previously employed by Thompson Health Care?     Yes (please specify)       No


Have any of your relatives ever been employed by Thompson Health Care?     Yes       No

Have you ever had a work related injury or medical condition?     Yes (please specify)       No

Have you ever filed a workers compensation claim?     Yes (please specify)       No

Preferred Referees


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Please tick to agree to our terms

  

I certify that the information given in this application form is correct in every detail.
I agree my employment is subject to a satisfactory criminal reference check. I understand that I am responsible for obtaining and providing this check upon commencement of my employment.
I accept that if I have given any false information I shall be liable to have my services terminated.
I give Thompson Health Care permission to check with my former employers any information relevant to my application.
I give permission for Thompson Health Care to contact any of my past employers for a reference.
As a condition of my employment I agree to comply with the safety rules and procedures and the safe working practices required by Thompson Health Care.

  I have read and understand/agree to the terms and conditions.