BELLFIELD College
APPLICATION FOR EMPLOYMENT SUPPORT STAFF
Please email your completed application form with your resume, and 100 points of identification to hr@bellfield.nsw.edu.au Proof of Identity Proof of Identity (this requires evidence to 100 points as per the list below). At least one document must contain a photograph. •
70 points
•
40 points
•
25 points
Current Australian Passport OR Australian Birth Certificate (Only one) Current Australian Driver’s License or NSW PhotoID Foreign Driver’s License OR Any other identity card photo or Medicare Card or utility bill
APPLICANT DECLARATION Each question must be answered and ticked either YES or NO. If YES, details must be provided, and you may be contacted for further details. Each declaration must be answered and signed. 1. PERSONAL DETAILS Family Name: Given Name/s: Title: (Mr, Mrs, Ms, Miss, Dr etc) Date of Birth: Permanent Address: Email Address: Phone Number:
Home:
Mobile:
COVID-19 Vaccination status?
□ YES □ NO https://legislation.nsw.gov.au/file/Public%20Health%20%28COVID19%20Vaccination%20of%20Education%20and%20Care%20Workers%29%20Order%202021.pdf
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Are you of Aboriginal or Torres Strait Islander origin?
□ No □ Aboriginal □ Torres Strait Islander Australian Resident:
□ Yes □
No
2. WORKING WITH CHILDREN CHECK The Working With Children Check (WWCC) is a requirement for anyone who works or volunteers in childrelated work in NSW. It involves a National Police Check (criminal history record check) and a review of reportable workplace misconduct. WWCC Number: Expiry Date: Type of Clearance: Date of Birth: For further details, please visit: https://www.service.nsw.gov.au/transaction/apply-working-children-check
3. AVAILABILITY
Position for which you are applying_____________________________________________________________
□ Monday □ Tuesday □ Wednesday
□ Thursday
□ Friday
4. ACADEMIC RECORD Tertiary Education
(including current incomplete courses)
Include any other relevant qualifications such as first aid certificate, short course, bus licence etc. Please attach transcripts where relevant Name and Location of Institution
Award
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Year of Completion
5. EMPLOYMENT DETAILS Employment History - Past Employment From
To
Name of Employer
Full-Time, Part-time or Temporary
6. REFEREES AND REFERENCES Referees Information Name
Company/Position/Relationship
Contact Number
7. EMPLOYMENT SCREENING
Working With Children Check numbers need to verified by the College before a person can commence working at the College.
Declaration: Have you been convicted of an offence that would bar you from child related work? Are you currently subject to any criminal investigations that may impact your ability to engage in child related work? Have you ever had a Working with Children Check (WWCC) clearance revoked or cancelled or been the subject of an interim bar? Note – The Working With Children Check has different names in some States and Territories in Australia. Have you ever been informed of, or been the subject of, a risk assessment being conducted into your suitability to hold a WWCC (however named)?
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Yes
No
Have you ever been convicted of an offence carrying a penalty of imprisonment? Do you have any illness/injury/health problems that may render you unable to carry out the requirements of the desired position? Do you have a Workers Compensation illness/injury that may render you unable to carry out the requirements of the desired position?
If you have answered yes to any of the following questions, please attach details.
8. EMPLOYMENT DOCUMENT CHECKLIST
Document
Yes
No
Working with Children Check Number Australian Immunisation COVID-19 digital certificate ‘100 point’ proof of identity Other Degrees, Diplomas or Certificates including First Aid Certificate Professional Referee details
Please read and sign the following: I certify that the information provided by me in this Application Form is complete and correct in every detail, and I understand that deliberate inaccuracies or omissions may result in non-acceptance of this application and/or the termination of any employment offered.
Applicants Name:
Applicants Signature:
Date:
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