Employment EOI

EMPLOYMENT EXPRESSION OF INTEREST

Date

Do you identify as Aboriginal/Torres Strait Islander?

YESNO

First Name

Surname

Are you an Australian citizen or resident?

YESNO

Email Address

Mobile

Home Address

Home Ph

Suburb

State

Postcode

POSITION

Work placement details

Other Allied Health Practitioner Details

WORK AVAILABILITY / PREFERENCE

I can start work by (eg 9am)

I need to finish work by (eg 4pm)

Maximum hours per week

INCOME EXPECTATIONS

What are your income expectations?

Hourly Rate

Annual Salary

DETAILS OF CURRENT EMPLOYMENT

Do you need to give notice to current employer?

YESNO

How Long?

Do you have any upcoming commitments/pre-booked holidays?

YESNO

Give Details

Do you have a 2nd Employer / Job?

YESNO

Give Details

REFEREES / REFERENCE NOMINEES

Referee #1

Company

Person to contact

Title

Business Phone No.

How long have you known Referee #1?

Referee #2

Company

Person to contact

Title

Business Phone No.

How long have you known Referee #2?

Referee #3

Company

Person to contact

Title

Business Phone No.

How long have you known Referee #3?

Occupational Licences & Certificates

First Aid

First Aid - Basic

First Aid - Senior

Perform CPR

Drivers Licence

C' Class

Signed

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