Support Coordinator Application Form

Contact Details

Preferred Name

First Name

Last Name

Date of Birth

Which of the following most accurately describe(s) you?

Male

Female

Non-binary

Transgender

Intersex

Prefer not to say

Other

If Other, please describe here

Preferred Pronouns

Residential Address

State

Postal Code

Mobile Number

Email Address

Entitlement to work in Australia

Best Contact Method

Phone Email

About You

Interests

Are you aware of any pre-existing injury or condition that may be affected by this work? If yes, please disclose below (Failure to disclose may result in no Work cover entitlements)

Select 3 of the following which best describes you?

Professional Attitude

Strong Work Ethic

Willingness to Learn

Previous Experience with Disability

Responsive

Effective Communicator

Resourceful

Adaptable

Shows Initiative

Attention to detail

How did you find out about this position?

If Other, Specify Source

Please let us know about what's important to you in your next role

Three things most important to you in your next role

Working conditions

Working hours

Flexible work options

Values of the organisation

External reputation of the organisation

Remuneration

Challenge/Job growth

Career Opportunities

Job Security

Training/Learning Opportunities

Access to equipment/tools/resources

Access to support and regular communication from organisation

Commute time

Employment

Current Employment Status

Casual Part-time Full-time Seeking Employment

Availability or Notice Period

Any comments on your current work status? (Intention to leave or retain current job role, is your current employer unaware of this application)

Have you worked/had experience in the Disability Field before?

Yes No

Qualifications & Training

Have you completed a Certificate IV in Disability?

Yes No Currently Undertaking Interested in Undertaking

Please detail qualifications and training you have completed or are currently undertaking

Do you have a current Level 2 First Aid Certificate?

Yes No Currently Undertaking Interested in Undertaking

Mandatory Checks

Are you willing to undertake the NDIS Worker Screening Check?

Yes No Already Completed

Are you willing to undertake an Employee Working with Children Check (Cannot be Volunteer)

Yes No Already Completed

Have you been charged or convicted of a criminal offence in Australia or overseas?

Yes No

If yes, you are required by law to outline the nature and date of the offence(s), other than convictions under Commonwealth Law that occurred more than ten years ago

Do you have a current Victorian Driver Licence?

Yes No

Resume

Upload Resume

Choose a file

Max. size: 6.0 MB

Questions

Do you have a good working knowledge of the NDIS? Please detail what this is

Please detail how your previous work experience would apply to this role

Professional Reference 1 (No Character References permitted)

First Name

Last Name

Relation to Applicant

Organisation

Contact Number

Email Address

Professional Reference 2 (No Character References permitted)

First Name

Last Name

Relation to Applicant

Organisation

Contact Number

Email Address

Professional Reference 3 (No Character References permitted)

First Name

Last Name

Relation to Applicant

Organisation

Contact Number

Email Address

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Support Coordinator Application Form