Home $ Work With Us $ Employment Application Form Employment Application Form Step 1 of 3 33% Full name:*Previous Names, Maiden Name/s, alias or aka’s:* Male Female Aboriginal Torres Strait Islander Cultural and Language Diverse Address:* Street Address City State / Province / Region AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Contact phone numbers:Mobile:*Email* Career Opportunities(Please select all that interest you) Support Worker Senior Support Worker Team Leader Office Staff Referees (Two of these need to be people who can comment on your work performance, we prefer previous supervisors/managers)Name:*Position*Organisation*Contact details*Name:*Position*Organisation*Contact details* Suitability for positionWhy do you want to work with CHSS?*Please describe what would be important to you in the way you would work with people with disability?*What do you like most and least about working in a team environment?*If we could provide you with the opportunity to contribute and share your skills, strengths, talents or interests with CHSS and our clients. What would you be willing to share?*Availability*Please detail any days you will be available to work.Are you currently working? If so, how many hours per week?*Job Adaptation/Modification:*Do you have any illness, injury or disability which may require adaptation of the work environment or modification of the Support Worker duties? Yes No Please provide details of environment or job adaptation/modification:Complex Manual Handling*Support Workers are required to undertake complex manual handling in all aspects of their daily work. A good level of fitness, flexibility and the ability to lift, push, pull, bend, squat and manoeuvre clients and equipment for up to 8 hours per shift is required. Are you able to perform the inherent physical requirements of this position for up to 38 hours per week? Yes No Essential CriteriaAs a support worker, you are required to:Hold a current NSW drivers licence* Yes No Willing and eligible to obtain an NDIS Worker Screening Check* Yes No Unsure NDISWC Number (if known): NDISWC NumberWilling to complete NDIS Worker Orientation* Yes No Unsure Consent to a physical assessment* Yes No First Aid Certificate* Yes No Supporting DocumentsCV Upload*Please upload your CVAccepted file types: pdf, doc, docx, Max. file size: 4 MB.
