Employment Application

Employment Application

THIS APPLICATION FOR EMPLOYMENT DOES NOT GUARANTEE THAT YOU WILL OBTAIN AN INTERVIEW
The information you provide is the first step in our employment process and will enable us to consider you for positions which may arise from time to time.
If a position becomes available and this application meets our selection criteria, you may be contacted for additional information, interview and to attend a pre-employment medical examination.

The information provided in this application is used for the purpose of our recruitment and selection procedures and to support any subsequent employment offer made to you. We may seek confirmation of details from past employers, referees or other sources.
The details provided remain confidential to our organisation or appointed recruitment agency and will not be provided to any other person.
PERSONAL INFORMATION
Name

First Name Last Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number

Area Code Phone Number
Email
example@example.com
INFORMATION ABOUT THIS APPLICATION
What type of work are you seeking with our organisation? (Tick one or more of the following).

Registered Nurse Enrolled Nurse Extended Care Assistant Receptionist Clerical Qualified Cook Catering Cleaning Laundry Maintenance Gardener Bus Driver
Do you have any qualifications/certifiates relevant to the type of work you are seeking?
Do you have any prior experience relevant to the type of work you are seeking?
PREVIOUS EMPLOYMENT OR WORK EXPERIENCE HISTORY
Name of Most Recent Employer:
Business Address:
Position Held:
Date Left:

Month Day Year
Date
How long were you employed?
Reason for Leaving:
Please provide details of other previous employers:
Name of Employer:
Business Address:
Position Held:
Date Left

Month Day Year
Date
How long were you employed?
Reason for leaving
Name of Employer:
Business Address:
Position Held:
Date Left

Month Day Year
Date
How long were you employed?
Reason for leaving
If not previously employed, please provide details of any previous work experience:
GENERAL INFORMATION
What is your understanding of Meercroft Care Inc.'s Vision and Mission?
Please list any personal qualities you have which you believe may assist your application.
Please provide details of two people we may contact as referees. They need to be people you have reported to in previous roles i.e. supervisors, managers, team leaders etc.
Employee Referee:
Name:
Current Occupation
Their occupation at the time you worked with this person:
Phone Number

Area Code Phone Number
Email
example@example.com
Employee Referee:
Name:
Current Occupation
Their occupation at the time you worked with this person:
Phone Number

Area Code Phone Number
Email
example@example.com
DECLARATION OF APPLICANT
I hereby authorise Meercroft Care Inc to obtain references by speaking with my nominated referees to verify any information relevant to this application.

I certify that the information given in this application is true and complete and I am aware that any inaccurate statements made herein or information deliberately withheld may later jeopardise my employment.

I acknowledge that this application does not constitute an offer of employment and that any offer subsequent to this application will be subject to satisfactory completion of a preemployment medical examination.

I acknowledge that if I progress to an interview, I must provide evidence of my ability to legally work in Australia such as Australian Citizenship Certificate, Australian Birth Certificate, Australian Passport (if born in Australia) or Passport of your country origin if not born in Australia, as well as Right to Work (in Australia) Visa if relevant.
Name

First Name Last Name
Signature

Clear
Date

Month Day Year
Date
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