GLENVALE SCHOOL APPLICATION FOR EMPLOYMENT

Part 1 – Applicant Details

Surname: / First Name:
Address:
Mobile Number: / Phone Number :
Position applied for: / When are you available to start work?
Photographic ID provided: Driver’s Licence Passport  Other  ______
Name of Current / Last Employer
Position/Step Level:
Salary / Wage: / $
Length of Service: / From / To
Reason for leaving:
Describe duties and responsibilities:
Name and Position of immediate Supervisor:
Previous Employment
Name / From / To / Last Position Held / Reason for leaving
Education
Level of Education / Name of Qualification, Certificate, Course
Include any subjects you have taught or may be able to teach
(Please provide copies of documents to your interviewer)
Pre-Employment Health Assessment
Have you had any previous injuries or Workers Compensation Claims and do you have any impairment, medical condition and/or special needs that may need to be addressed or that would affectyour ability to safely and competently perform the duties of the position you have applied for?
Yes No
If Yes, please give details:
Will you agree to undergo a pre-employment health assessment specific for the requirements of the position
as a part of the selection process? Yes  No 
Legally Entitled to Work in Australia
Are you a permanent resident of Australia? / Yes No
If Yes, evidence provided: / Australian Birth Certificate 
Australian Citizenship Certificate 
Australian Passport 
Certificate of evidence of residency status 
If No, do you have a valid visa with the right to work in Australia?
(Please provide a copy to your interviewer) Yes No
Visa Expiry Date:
Security Clearance, Criminal Records Check, Driver’s Licence
Some roles require checking for security and safety purposes either prior to commencing employment or during employment.
Do you have a valid V.I.T. Registration?
(If yes, please provide a copy to your interviewer) Yes No
Teacher Registration No. ______Valid to Subjects
Do you have a valid Working with Children Certificate/Card?
(If yes, please provide a copy to your interviewer) Yes  No 
Some roles are required to have current drivers and other necessary licences to perform the role.
Do you have a current Australian Driver’s Licence? (If yes, please provide a copy to your interviewer)Yes No
Driver’s Licence No: ______
Other skills and competencies Yes No
Description: ______
______
______
Referees
(Note: referee must be a person to whom candidate has reported in the past 5 years. If you have previously worked for (Name of Company), please nominate at least one referee from this role)
Name / Position / Company / Contact Number
Read this carefully before signing
I understand that this form is an Application for Employment and its completion does not mean that I have been successful in the recruitment process, ie. it is no guarantee of employment. I certify that the information on this form is true and correct and I understand that the misrepresentation or omission of facts may be sufficient grounds for rejection of my application and / or termination of employment
I hereby authorize any of my former employers to furnish their records of my employment.
Signed: / Date:

#21040- 25 October 2013