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(03) 9576 7000
Carer Application Form - Part 1
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9
Personal Details
Details
(Required)
First Name
Last Name
Email
(Required)
Have you ever attended an interview or gained work through Australia's Leading Home Care Agency/ Melbourne's Leading Nanny Agency?
(Required)
No
Date of Birth
(Required)
DD slash MM slash YYYY
Home Phone
Mobile Phone
(Required)
Address
(Required)
Street Address
Suburb
State
Post Code
Where did you first hear of us?
(Required)
- select an option -
Child Care Jobs Website
Current CARER
FACEBOOK
IHC BYO Nanny
Indeed
Jora
Other
Seek
We Need a Nanny
Have you spoken to an ALHCA/ MLNA staff member and already booked an interview?
(Required)
Yes
No
Do you know anyone who has or is currently working for our agency?
(Required)
Yes
No
Are you a smoker?
(Required)
Yes
No
License Details
Do you have your own car?
(Required)
Yes
No
Do you have a Drivers License?
(Required)
Yes
No
Issuing State/ Territory
(Required)
- select an option -
NSW
VIC
QLD
WA
SA
ACT
NT
ID Expiration Date
DD slash MM slash YYYY
Drivers License Number
Car Registration
Upload a copy of your Drivers License
Accepted file types: jpg, png, gif, webp, pdf, Max. file size: 5 MB.
Citizenship Details
Are you an Australian Citizen/ Permanent Resident?
(Required)
Yes
No
Do you hold a current Australian Visa?
(Required)
Yes
No
If yes, What Visa are you on?
(Required)
Visa Expiration Date
DD slash MM slash YYYY
List any working restrictions
Upload a copy of your Visa
Accepted file types: jpg, png, gif, webp, pdf, Max. file size: 5 MB.
Working with Children Check
Do you have a Working with Children Check/ Blue Card
(Required)
Yes
No
If yes, WWCC type?
(Required)
- select an option -
Employee
Volunteer
WWCC Number
(Required)
WWCC Expiration Date
DD slash MM slash YYYY
Upload a copy of your WWCC
Accepted file types: jpg, png, pdf, gif, webp, Max. file size: 5 MB.
Criminal History
Have you ever been charged with a criminal offense?
(Required)
Yes
No
Do you have a Police Check?
(Required)
Yes
No
If yes, Police Check Date
(Required)
DD slash MM slash YYYY
Upload a copy of your Police Check
Accepted file types: jpg, png, pdf, gif, webp, Max. file size: 5 MB.
First Aid & Medical Certificates
First Aid Type
(Required)
**HLTAID012 is required prior to commencement
- select an option -
HLTAID011 - Provide First Aid
HLTAID012 - Provide an Emergency First Aid Response in an Education and Care Setting
Other
None
First Aid Expiration Date
DD slash MM slash YYYY
Upload a copy of your First Aid Certificate
Accepted file types: jpg, png, pdf, gif, webp, Max. file size: 5 MB.
This field is hidden when viewing the form
Are you fully vaccinated for COVID-19
Yes
No
Undisclosed
Upload a copy of your COVID-19 Vaccination Certificate
Accepted file types: jpg, png, pdf, gif, webp, Max. file size: 5 MB.
Education
Qualification 1
Qualification Type
(Required)
- select an option -
VCE or Year 12 Equivalent
Early Years / Primary Teaching Degree
Primary Teaching Degree
Secondary Teaching Degree
Qualified OSHC Educator
Early Childhood Educator
International Nanny Certificate
International Childcare Certificate
Certificate III of Children's Services (Level Educator)
Certificate III of Early Childhood (Level Educator)
Diploma of Early Childhood (Level Educator)
Children's Therapist (Occupational, Speech Pathology, Psychology)
Qualified Nurse
Midwife/Mothercraft Nurse
Food Handling Certificate
Chef/Cook/Dietitian/Nutritionist
Medical Degree
Other
No Formal Qualification
Qualification Information
Date Completed
DD slash MM slash YYYY
Upload a copy of your Qualification
Accepted file types: jpg, png, pdf, gif, webp, Max. file size: 5 MB.
Qualification 2
Qualification Type
- select an option -
VCE or Year 12 Equivalent
Early Years / Primary Teaching Degree
Primary Teaching Degree
Secondary Teaching Degree
Qualified OSHC Educator
Early Childhood Educator
International Nanny Certificate
International Childcare Certificate
Certificate III of Children's Services (Level Educator)
Certificate III of Early Childhood (Level Educator)
Diploma of Early Childhood (Level Educator)
Children's Therapist (Occupational, Speech Pathology, Psychology)
Qualified Nurse
Midwife/Mothercraft Nurse
Food Handling Certificate
Chef/Cook/Dietitian/Nutritionist
Medical Degree
Other
Qualification Information
Date Completed
DD slash MM slash YYYY
Upload a copy of your Qualification
Accepted file types: jpg, png, pdf, gif, webp, Max. file size: 5 MB.
Qualification 3
Qualification Type
- select an option -
VCE or Year 12 Equivalent
Early Years / Primary Teaching Degree
Primary Teaching Degree
Secondary Teaching Degree
Qualified OSHC Educator
Early Childhood Educator
International Nanny Certificate
International Childcare Certificate
Certificate III of Children's Services (Level Educator)
Certificate III of Early Childhood (Level Educator)
Diploma of Early Childhood (Level Educator)
Children's Therapist (Occupational, Speech Pathology, Psychology)
Qualified Nurse
Midwife/Mothercraft Nurse
Food Handling Certificate
Chef/Cook/Dietitian/Nutritionist
Medical Degree
Other
Qualification Information
Date Completed
DD slash MM slash YYYY
Upload a copy of your Qualification
Accepted file types: jpg, png, pdf, gif, webp, Max. file size: 5 MB.
Experience
Have you ever worked with children with special needs?
(Required)
Yes
No
If yes, What sort of needs?
Have you had experience with any of the following? (Tick more than one if needed)
Anaphylaxis
Epipen
Working with Asthma
Sleep Settling
Overnight Stay
Twins
Triplets
What age groups have you cared for?
(Required)
- select an option -
Newborns +
3 months +
6 months +
9 months +
12 months +
18 months +
2 years +
3 years +
4 years +
5 years +
8 years +
Have you ever represented another agency?
(Required)
Yes
No
How would previous employers describe your personality?
(Required)
Cooking Skills
(Required)
- select an option -
None
Basic
Good
Excellent
Swimming Skills
(Required)
- select an option -
None
Average
Strong
Musical Skills
(Required)
Languages
(Required)
Hobbies
(Required)
Employment History / References
Referee 1
Your position held
(Required)
Start Date
DD slash MM slash YYYY
Finish Date
DD slash MM slash YYYY
Referee Name
(Required)
Referee Phone
Referee Email
Referee 2
Your position held
(Required)
Start Date
DD slash MM slash YYYY
Finish Date
DD slash MM slash YYYY
Referee Name
(Required)
Referee Phone
Referee Email
Referee 3
Your position held
Start Date
DD slash MM slash YYYY
Finish Date
DD slash MM slash YYYY
Referee Name
Referee Phone
Referee Email
Desired Employment
How far will you travel for placements? (mins)
(Required)
Are you happy to travel with the family?
(Required)
Yes
No
How long do you intend to represent our agency?
(Required)
- select an option -
3 months
6 months
12 months
12 months +
Details for any upcoming holiday or study plans?
Which duties are you wishing to provide to ALHCA / MLNA clients (tick more than one if needed)
(Required)
After/Before School Care
Mothercraft Nurse/ Night Nanny
Babysitting
Mother's Helper/ Nanny
Cleaner
Nanny Day
House/Animal Sitting
Nanny/Housekeeper
Housekeeper
Party Help
Live in Hanny/HK
Which tasks are you willing to carry out on duty? (tick more than one if needed)
(Required)
Ironing children's clothing
Ironing family's clothing
Prepare children's meals
Cooking children's meals
Prepare family's meals
Cooking family's meals
Washing children's clothing
Washing family's clothing
Changing and washing children's bed linen
Changing and washing family's bed linen
Sweep, Vacuum, and mop family living areas
Sweep, vacuum and mop entire home
Driving family in your car
Driving family in their car
Take children to extra curricular activities
Bathing children
Shopping for family
Fill out communications diary
Post letters, pay bills and assist with the administration
Availability and Confirmation
Monday
Morning 7am - 11:59am
Early After Noon - 2:59
Late Afternoon 3pm - 6:29pm
Evening 6:30pm - 11:59pm
Overnight 12am - 6:59am
Select All
Tuesday
Morning 7am - 11:59am
Early After Noon - 2:59
Late Afternoon 3pm - 6:29pm
Evening 6:30pm - 11:59pm
Overnight 12am - 6:59am
Select All
Wednesday
Morning 7am - 11:59am
Early After Noon - 2:59
Late Afternoon 3pm - 6:29pm
Evening 6:30pm - 11:59pm
Overnight 12am - 6:59am
Select All
Thursday
Morning 7am - 11:59am
Early After Noon - 2:59
Late Afternoon 3pm - 6:29pm
Evening 6:30pm - 11:59pm
Overnight 12am - 6:59am
Select All
Friday
Morning 7am - 11:59am
Early After Noon - 2:59
Late Afternoon 3pm - 6:29pm
Evening 6:30pm - 11:59pm
Overnight 12am - 6:59am
Select All
Saturday
Morning 7am - 11:59am
Early After Noon - 2:59
Late Afternoon 3pm - 6:29pm
Evening 6:30pm - 11:59pm
Overnight 12am - 6:59am
Select All
Sunday
Morning 7am - 11:59am
Early After Noon - 2:59
Late Afternoon 3pm - 6:29pm
Evening 6:30pm - 11:59pm
Overnight 12am - 6:59am
Select All
Would you like to attach a Resume to your application?
Accepted file types: pdf, png, jpg, docx, doc, webp, jpeg, Max. file size: 5 MB.
I confirm that all information provided is accurate and current, and I give my consent to ALHCA / MLNA to contact my references.
(Required)
Yes
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