Your Name (required)

Your Contact Number (required)

Email (required)

Course (required)
-----Certificate III Individual Support (Ageing)Certificate III Individual Support (Disability)Certificate III Health Services AssistanceCertificate IV Ageing SupportCertificate IV DisabilityCertificate IV Leisure & Health

Suburb

First Aid Completed? -----YesNo

Manual Handling Completed? -----YesNo

Fees paid in full? -----YesNo

Drivers Licence Available? -----YesNo

Upload Licence Copy

Police Clearance Certificate? -----YesNo

Upload Police Clearance Certificate

Vaccination Status -----Fully VaccinatedHad one doseNo Vaccination yet

Do have a Working with Childrens check (WWCC)? (Required for Certificate III Individual Support (Disability) or Certificate IV Disability.) -----YesNo

Upload Working with Childrens check (WWCC)

NDIS Screen Check (NDISWC) (Required for Certificate III Individual Support (Disability) or Certificate IV Disability.) -----YesNo

Upload NDIS Screen Check (NDISWC)

FLU Vaccination Record (Required for Certificate III Individual Support (Ageing) or Certificate IV Ageing). -----YesNo

Upload FLU Vaccination Record

Vaccination Card (Required for certificate III health service assistance (acute care)) -----YesNo

Upload Vaccination Card

Do you have any concerns that could impact your placement such as health issues or pregnancy? If so please specify below

What date would you like to start (Preference only, we will try our best to accommodate your request)?

Please advise of the days and times you are available to complete your placement (Preference only, we will try our best to accommodate your request)

Do you have any preferred locations (Preference only, we will try our best to accommodate your request)?

Any other comments?