Are you of Aboriginal or Torres Strait Islander Descent:

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1 STAFF RECRUITMENT REGISTRATION PERSONAL PROFILE & SKILL AUDIT ASSESSMENT The information provided will be utilised solely for the purpose of Incompro Aboriginal Association s Recruitment and Training. PERSONAL DETAILS Are you of Aboriginal or Torres Strait Islander Descent: Family Name: Given Name(s): Preferred Name: Date of Birth: / / Address: Suburb: Postcode: Gender Male / Female Mobile Phone: Phone: Emergency Contact: Phone: Relationship to you: Do you have a disability What can you tell me about your disability? Has it stopped you from getting a job in the past? Do you have: DCSI Clearance (s) o Vulnerable Person o Disability Service Sector o Child Related Employment Child Safe Environments 100 point of ID Tax File Number Senior First Aid Certificate Manual Handling Certificate SA Drivers License

2 My current status is Unemployed Studying College / University Working Part-time Working Full-time Disability Pension Studying High School If Unemployed how long have you been unemployed? 6 months 12 months Longer than 12 months Other e.g. doing voluntary work, carer for a family member etc. (Please specify) I am seeking work within Tick the boxes that are appropriate for you: Indigenous Mentor Indigenous Youth Worker Client Services Officer Administration Officer Project Officer / Management Case Manager Volunteer I am seeking work Full Time Part Time Casual I would like assistance in the following Training Certificate 3 Individual Support Certificate 4 Youth Work First Aid Certificate Child Safe Environments Indigenous Mentoring Manual Handling Do you have a Job Active Provider Employment Service Provider: Telephone: Employment Consultants Name: Suburb: Jobseeker ID: Client Registration What type of benefit do you receive (if applicable):

3 Education, Skills and Experience What is your highest level of education completed: Year completed (e.g. year 10, 11 etc.) TAFE / College attended Years Courses Completed: University attended Years Other (please specify) Do you have a copy of your Certificates Have you had any other educational experiences or gained other qualifications that would be helpful for you to get a job?? First Aid Child Safe Environments Other Other (please specific) Do you have a Resume? (please provide a copy) Communication skills My communication skills are Poor Good Excellent If you have problems with communication, please tell us more about it (e.g. I find it hard to understand what people are saying). My reading skills are Poor Good Excellent My writing skills are Poor Good Excellent My computer skills are Poor Good Excellent My Math Skills are Poor Good Excellent What else can you tell us about yourself?

4 Transport Do you have your own vehicle? Do you have a current Drivers Licence? Car Light Truck/ Bus Family Do you have Children? Ages Do you need Child Care? Do you currently care for anyone else full time (i.e. family member, partner etc.) Health Do you have any health issues? Please tell us more about your health issues (ie diabetes, hearing problems, blood pressure)? Do you have prescribed medications for any of your health issues / illnesses? Do you have any other health issues or any previous or existing injury that may prevent you from doing some components of your work? (please tell us more) Authorisation By signing this Registration form, I certify that the information I have provided on this form is true and correct, and I authorise InComPro to utilise the information I have provided for the purposes of InComPro s Recruitment and Employment of staff. Participants full name: Participants signature: Date: / / If you are under 18years of age parent/guardian need to also sign this Authorisation. Parent / Guardian s full name: Parent / Guardian s Signature: Date: / /

5 Application for Employment Form Position/s Applied for Applicants Details Given name: Family name: Street address: Date Of Birth: Postal address: Are you an Aboriginal or Torres Strait Islander? Are you an Australian citizen or Have the status of permanent resident in Australia? Home Ph: Work Ph: Mobile Ph: Current driver s license number: Pre-Employment Essential Criteria (Applicants need to meet these criteria or do so before employment begins) Do you have a current DCSI Screening Checks (if a positive police clearance is recorded, employment may still be allowed depending on the nature and times of the offending) Yes No Current South Australian Drivers Licence Yes No Senior First Aid Certificate Yes No Life Experience Please briefly detail your life experiences, not only work but significant travel, hobbies, interests, raising a family etc

6 How do you think the experiences above will help you to be an effective worker with InComPro Inc: What experiences / training have you had that supports you to provide services to people/clients: Work Experience Have you any previous experience working with people with a disability / Youth who require on-going support / care? This can be paid work, as a volunteer, or as a carer. Have you any work experience with Aboriginal people / community? Please provide details: Training/Courses/Qualification

7 Name of Course Date Completed Still Studying Date Left Course Other Skills and Abilities (Relevant to the Position) Medical History Failure to disclose pre-existing medical conditions could by default lead to the organisation breaching the Work Health & Safety Act and place a worker at risk. This is therefore an offence and could result in immediate dismissal. The requirements of this position can involve some repetitive work including minor lifting and bending. Is there anything in your medical history that would prevent you from meeting this requirement? YES / NO Staff are required to have an ability to work under pressure, work with a potentially difficult client base, meet important timelines, and routinely engage with clients and other staff whenever necessary. Is there anything in your medical history that would prevent you from meeting this requirement YES / NO If there is a Yes answer to either of the above questions please provide details below: Applicants name Applicants signature Availability... Date

8 Desired Position Incompro offers different positions, please indicate the type of employment you are seeking. Full Time Permanent / Part Time Casual Please add more detail regarding your availability (if required) If you have any queries regarding your application, or any other matter, the Contact Person will be able to assist you. You will be notified of the results of your application as soon as practicable. If you are called for an interview and have any special requirements (e.g. wheelchair access to building), advise the Contact Officer. The corporation is not required to refund any costs involved in attending interviews. Office Use Only Date of notice to applicant: Interview: Yes No Interview date/time: Docs sighted by: