Employment Expression of Interest
Strictly Confidential
It is the policy of OneCare to fill positions on the basis of merit. All
appointments will therefore be based on the applicants’ ability to successfully
meet the essential and inherent job requirements as detailed in the position
description.
The expression of interest form is a source of information, which will be used by
OneCare to assist us in considering your suitability for any positions which may
become available in the future. Failure to supply the information requested may
hinder OneCare’s ability to assess your suitability for the positon.
Given the nature of our business, OneCare is subject to the provision of a
National Police Check and a pre employment health assessment.
OneCare shall retain all information relating to unsuccessful applications for a
period of 3 months from the date of this application.
Thank you for your interest in working with OneCare.
Personal Details
First Name(s):
Surname:
Address:
Home Phone:
Mobile:
Email:
Do you hold a current Driver’s License?
☐ Yes
☐ No
Drivers License type and number:
Are you an Australian Citizen/Permanent Resident? ☐ Yes ☐ No
If no, do you have a working visa?
☐ Yes
☐ No
Visa Type (please also include all details with your application):
Position(s) of Interest
Nature of work:
☐ Cleaning
☐ Catering
☐ Laundry
☐ Personal Care
☐ Administration
☐ Gardening
☐ Nursing
☐ Management
☐ Maintenance
Location:
☐ Corporate Administration, Hobart
☐ The Manor Complex, Kings Meadows
☐ Bishop Davies Court, Kingston
☐ Rubicon Grove, Port Sorell
☐ Home Care South, Kingston
☐ Umina Park, Burnie
☐ Barossa Park Lodge, Glenorchy
☐ Home Care North, Kings Meadows
Minimum Hours Preferred: ___
Maximum hours preferred:___
Preferred employment status
☐ Full Time
☐ Part Time
Are you available to complete shift work?
☐ Casual
☐ Yes
☐ No
Days available:
☐ Monday
☐ Thursday
☐ Saturday
☐ Tuesday
☐ Friday
☐ Sunday
☐ PM
☐ Night
☐ Wednesday
Times Available
☐ AM
General
Do you have any family members living or working at a OneCare site?
☐ Yes
☐ No
Please provide details:
Can you think of any reason, including any medical issue, which may affect your ability to
perform the inherent requirements of the position, including regular attendance at work?
☐ Yes
☐ No
Please provide details:
Do you have any other known condition which might affect you ability to safely perform the
inherent requirements of the position, including that may impact on the safety of employees or
clients?
☐ Yes
Please provide details:
☐ No
Education & Qualifications
Please list any appropriate education, professional or trade qualifications that are relevant to
the position you are applying for. Proof will be required before employment
Qualification
Institute
Year of Completion
Eg. Certificate III Aged Care
Work & Training
2011
Would you consider completing a qualification?
☐ Yes
☐ No
If ‘Yes’ what would you like to complete a qualification in?
Professional Registrations
Please list any professional registrations you hold that are relevant to the position you are
applying for. Proof of these registrations will be required prior to employment.
Registration
Expiry Date
Registration Number
Eg. Registered Nurse
30 June 2015
NWM0000031
Employment Details
What is your current employment status:
☐ Employed
☐ Self Employed
☐ Unemployed
Have you previously worked for OneCare?
☐ Yes
☐ No
Please provide location and dates:
Have you been the subject of disciplinary action or been dismissed by a previous employer?
☐ Yes
Please provide location and dates:
☐ No
Employment History
Briefly list your most recent employment history in the table below, starting with you current or most
recent position
Employer
Position Held
Start Date
End Date
Reason for leaving
Referees
Please provide the details of current or most recent supervisors who have agreed to be referees and
who can be contacted. If you have not worked before, teaching staff or volunteer supervisors may be
considered. By completing this section, you are giving permission for OneCare to contact your
nominated referees to provide information relevant to your application
Name
Company
Positon
Contact Details
Was this person
a direct
supervisor?
☐ Yes
☐ No
☐ Yes
☐ No
☐ Yes
☐ No
Workers Compensation Claims
A previous worker’s compensation claim is not a barrier to the consideration of an application for
employment with OneCare. This information assists us in assessing opportunities for your placement in
an appropriate environment.
Have you ever made a claim for Worker’s Compensation?
☐ Yes
Please provide details:
☐ No
Criminal Clearance
Employment with OneCare is subject to the provision of a satisfactory National Police Check
as required under the Aged Care Act 1997.
A criminal record does not necessarily disqualify an applicant. If rejection of your application
is considered solely because of a criminal record, you will be given the opportunity to discuss
the matter fully and confidentially with a senior member of staff before a decision is made.
Do you have any charges pending before any court?
☐ Yes
☐ No
Please provide details:
Workplace Smoking
Some OneCare sites are currently smoke free, whilst others are moving in this direction. As
such, employees are unable to smoke on site.
If you currently smoke, are you prepared to refrain whilst on duty?
☐ Yes
☐ No
☐ N/A
Declaration
I declare that the statements I have made and the information I have given are true to the
best of my knowledge and belief. I have not withheld any relevant information required by this
application, or made any false or misleading representations.
I acknowledge that if I have knowingly or wilfully given false or misleading information or have
withheld any information, it could result in:

Rejection of my application;

Legal proceedings against me; or

Dismissal after my appointment.
Applicant Signature:
Date: