IHC - Register Interest - Australia’s Leading Home Care Agency

Name(Required)

First Last

Date of Birth(Required)

Street Address(Required)

Suburb(Required)

Post Code(Required)

State(Required)

Mobile Phone(Required)

Home Phone

Work Phone

Email(Required)

Combined Annual Family Taxable Income(Required)

Child Care Subsidy Percentage(Required)

Please enter a number from 0.00 to 100.00.

How many Children do you have?(Required)

Child 1

It is important to fill in all information for all your children

First Name(Required)

Date of Birth(Required)

Child 2

First Name(Required)

Date of Birth(Required)

Child 3

First Name(Required)

Date of Birth(Required)

Child 4

First Name(Required)

Date of Birth(Required)

Child 5

First Name(Required)

Date of Birth(Required)

Child 6

First Name(Required)

Date of Birth(Required)

Child 7

First Name(Required)

Date of Birth(Required)

Position Description

Required Hours: So that we can give you the most accurate cost estimate possible, we need a snap shot, a sample scenario of the most typical or common example of the hours that you would require an educator to work on a regular weekly basis. Fill in the times based on the longest hours you would require on any given day. Include the time it takes to travel to and from work / study / training.

Monday

Shift 1 Start Time

:

Shift 1 Finish Time

:

Shift 2 Start Time

:

Shift 2 Finish Time

:

Tuesday

Shift 1 Start Time

:

Shift 1 Finish Time

:

Shift 2 Start Time

:

Shift 2 Finish Time

:

Wednesday

Shift 1 Start Time

:

Shift 1 Finish Time

:

Shift 2 Start Time

:

Shift 2 Finish Time

:

Thursday

Shift 1 Start Time

:

Shift 1 Finish Time

:

Shift 2 Start Time

:

Shift 2 Finish Time

:

Friday

Shift 1 Start Time

:

Shift 1 Finish Time

:

Shift 2 Start Time

:

Shift 2 Finish Time

:

Saturday

Shift 1 Start Time

:

Shift 1 Finish Time

:

Shift 2 Start Time

:

Shift 2 Finish Time

:

Sunday

Shift 1 Start Time

:

Shift 1 Finish Time

:

Shift 2 Start Time

:

Shift 2 Finish Time

:

Will this be the same time each week on a regular basis?(Required)

Yes

No

Are you flexible with the days and times required?(Required)

Yes

No

When would you like care to commence?(Required)

Is this position ongoing?(Required)

Yes

No

If No, Possible finishing date?

Do you plan to bring your own educator?(Required)

Yes

No

In Home Care

Have you spoken to the In Home Care Support Agency?(Required)

Note: If you haven't yet, we can introduce you later in the process.

Yes

No

Who is your Family Liaison Officer at the Support Agency?

Has the Support Agency created (or in the Process of Creating) your Family Management Plan?(Required)

Yes

No

Confirmation

I confirm that all information completed within my Registration form is true and accurate. I also agree to allow ALHCA to share my information with Educators, the In Home Care Support Agency, the Department of Education, the Department of Human Services, Child Care Subsidy Help Desk and Software Providers, fellow Service Providers, ACCS referral organizations and other authorized personnel.(Required)

Yes

IHC - Register Interest

Child 1

Child 2

Child 3

Child 4

Child 5

Child 6

Child 7

Position Description

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

In Home Care

Confirmation

Main Links

Resources

Quick Links