TeamKids Employment Application Form

PROHIBITION NOTICE DECLARATION FOR PROSPECTIVE STAFF MEMBERS
• This declaration is to be completed by any prospective staff member seeking employment or engagement with an education and care service

• This declaration will stay confidential and not be passed onto the regulatory authority
Are you currently subject to a prohibition notice under the Education and Care Services National Law? **

YesNo
Are you currently prohibited or restricted from working with children under any other law?*

YesNo
DECLARATION

I (person completing this form) declare that:

1. The information provided on this form is true, complete and correct
2. The approved provider or a representative of the approved provider is authorised to verify any information provided in this form
3. I am aware that under the Education and Care Services National Law penalties apply if false or misleading information is provided. *
By clicking the adjacent circle, you confirm your declaration.*

I confirm my declaration
Should be Empty:

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