Application Form

Application Form
Name*

TitleFirst NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Sex

MaleFemaleOther
Mobile Phone*

Area CodePhone Number
Home Phone

Area CodePhone Number
E-mail*
DOB*

DayMonthYear
Date
Nationality*
Do you have the right to work in Australia*

YesNo
Visa Restrictions*
EG Student Visa 20 hours
Do you have a car

YesNo
Are you willing to do regional blocks

YesNo
Position Applying For*

Registered NurseEnrolled NurseMed Comp AINAssistant in NursingDomesticHome CarerAdministrationPhysiotherapistExercise PhysiologistOccupational TherapistOTAPTAOther Allied Health
Status

FulltimeParttimeCasual
Availability

MondayTuesdayWednesdayThursdayFridaySaturdaySundayMainly MorningsMainly AfternoonsMainly NightsAnytime (only tick this is available 24/7)
How many shifts are you hoping to work weekly?

1-2 Days per week3-4 Days per week5 or as many as possible
Qualifications
Qualifications Completed*
Date Completed

DayMonthYear
Date
Qualifications Currently Being Studied*
Have you completed your 120 hours of Work Placement

YesNo
Where did you complete your 120 hours of Work Placement
Expected Completion Date

DayMonthYear
Date
Employment History
Business Name # 1
Position
Date Started

DayMonthYear
Date
Date Finished

DayMonthYear
Date
Business Name # 2
Position
Date Started

DayMonthYear
Date
Date Finished

DayMonthYear
Date
Resume*

Upload a File

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Cover Letter

Upload a File

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Police Clearance (within last 6 months)*

Upload a File

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*** REFEREES - Must be someone who has been your direct supervisor, manager or trainer in this field (This must be an RN, EN or trainer, Senior AINs are not applicatible as a referee). If you have not got a direct supervisor please contact us on 1300687731 or by email recruitment@compatiblecare.com.au to discuss ***
Referee 1*

First NameLast Name
Email - Preferred
example@example.com
Mobile
Position*
Referee 2*

First NameLast Name
Email - Preferred
example@example.com
Mobile
Position*
How did you hear about Compatible Care Nursing Agency*
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Enter the message as it's shown*
Email
example@example.com
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Application Form

Qualifications

Employment History