TraceCare application form

Thanks in advance for applying to join the TraceCare team!

To ensure the best care and safety for our clients, naturally we require a fair bit of info from you. This form is easiest to use when you’ve gathered together the following information beforehand:
- Safety and security clearances
- Residency/passport details if applicable
- Relevant education and qualifications
- Recent employment history
- References
- Your cover letter and CV in PDF format for uploading (maximum total 3MB)
Remember, if you have any questions, you’re very welcome to contact us. We want you to have the very best experience with TraceCare.
1. Regional availability
Your availability in Australia*
Please select all areas in which you will be available to work with us.
- NSW – Sydney metro
- NSW – regional
- ACT
- Victoria – Melbourne metro
- Victoria – regional
- Tasmania – Hobart metro
- Tasmania – regional
- Queensland – Brisbane metro
- Queensland – regional
- Western Australia – Perth metro
- Western Australia – regional
- South Australia – Adelaide metro
- South Australia – regional
- Northern Territory – Darwin metro
- Northern Territory – regional
2. Contact details
Name*
Prefix First Last
Address*
Street Address Address Line 2 City/town State/Territory Postcode Country
Is this also your postal address?*
- Yes
- No
Postal address (different from actual address)
Street address City/town State/Territory Postcode Country
Preferred contact phone*
Email*
3. Client safety
These are your certifications that ensure the personal health and safety of our clients.
First Aid certification*
Do you have a current certificate for HLTAID003 Provide first aid?
[Note: HLTFA301B, HLTFA301C, HLTFA311A have now all been superseded.]
- Yes
- No
Police Check*
Do you have a current police check for your state or territory?
- Yes
- No
- No but I have applied
Working with Children Check*
Do you have a current Working with Children Check for New South Wales?
- Yes
- No
- No but I have applied
and the WWC number for my application is:*
Working with wulnerable people (WWVP) registration*
Do you have current Working with vulnerable people registration for the Australian Capital Territory?
- Yes
- No
- No but I have applied for registration
Working with Children Check*
Do you have a current Working with Children Check for Victoria?
- Yes
- No
- No but I have applied
Blue Card*
Do you have a current Blue Card for Queensland?
- Yes
- No
- No but I have applied
Child related employment screening*
Do you have valid child related employment screening for South Australia?
- Yes
- No
- No but it is in process
Working with Children Check*
Do you have a current Working with Children Check for Western Australia?
- Yes
- No
- No but I have applied
Registration for working with vulnerable people*
Do you have current Registration for working with vulnerable people for Tasmania?
- Yes
- No
- No but it is in process
Working with children clearance – Ochre Card*
Do you have a current Ochre Card for the Northern Territory?
- Yes
- No
- No but I have applied
4. Citizenship and residency
This information simply provides the basis for our discussions about your employment with us, and allows us to follow up any necessary medical or other clearances required to ensure the most appropriate and satisfying work for you.
You reside in Australia as:*
- an Australian citizen
- a Permanent Resident
- a Temporary Resident
You identify as:*
- Aboriginal
- Torres Strait Islander
- Neither
What is your Temporary Resident visa status?*
What are your Temporary Resident work restrictions?*
Country of birth*
Nationality*
Passport number
Passport expiry date
5. Sector experience & suitability
Have you worked in the disability care sector previously in the last three (3) years?*
- Yes
- No
Have you worked in the aged care sector previously in the last three (3) years?*
- Yes
- No
Have you had experience working in a client's home?*
- Yes
- No
Have you had experience working with clients with a physical disability, mental illness, neurological or acquired brain injury?*
- Yes
- No
Please list all languages you speak (including Auslan or similar) or other skills which may be useful as a care or support worker.
Do you have a current driver's licence that enables you to drive in Australia?*
- Yes
- No
Do you have a reliable motor vehicle?*
- Yes
- No
Do you currently have an illness or injury which may affect your ability to safely perform the standard requirements of the position of a care or support worker?*
WHS restrictions may limit the roles for which you are suited, and you may require medical clearance. Standard requirements include such as bending, stooping, reaching, twisting and other repetitive physical actions involved in the manual handling of clients.
- Yes
- No
Please provide details.
Are there circumstances or facts not mentioned above that may affect your application? Please provide details.
Have you ever been employed by TraceCare or Trace Personnel?*
- Yes
- No
Have any of your relatives ever been employed by TraceCare or Trace Personnel?*
- Yes
- No
How did you hear about TraceCare?
Confirmation and consent*
I confirm that all my responses to the above questions are true and correct, because I understand that any false information could terminate my application or, in the future, lead to the termination of my employment. I also consent to a TraceCare representative verifying or seeking additional information on any matter regarding this application.
- I confirm and consent
6. Education & qualifications
Please name your qualifications in order of relevance to this application.
Qualification 1
Qualification
Institution
Year obtained
Qualification 2
Qualification
Institution
Year obtained
Qualification 3
Qualification
Institution
Year obtained
7. Employment history
Please list your last three positions held, most recent first.
Employer 1
Organisation
Position
Employed from
Employed to
Reason(s) for leaving
Employer 2
Organisation
Position
Employed from
Employed to
Reason(s) for leaving
Employer 3
Organisation
Position
Employed from
Employed to
Reason(s) for leaving
8. References
Please provide up to three referees and their contact details. They should not be friends or relatives.
Referee 1
Name
Organisation
Relationship
Contact phone and/or email
Referee 2
Name
Organisation
Relationship
Contact phone and/or email
Referee 3
Name
Organisation
Relationship
Contact phone and/or email
9. Work type
Please indicate the kinds of support you are willing to provide.
What position(s) are you applying for?
Please check the positions you would like to apply for and for which you are qualified in Australia.
- Registered Nurse (RN)
- Assistant in Nursing (AIN)
- Other
Position you're applying for
Daily living activities*
Showering, toileting, grooming, medication, meal preparation, mobility.
- Yes
- No
Domestic cleaning*
Dusting, vacuuming, washing, mopping, cleaning bathrooms/toilets, sweeping.
- Yes
- No
Transport assistance*
Assistance with transport, shopping, outings, paying bills.
- Yes
- No
10. Availability
Please check the specific days of the week and times of the day that you will be reliably available to work.

	0600- 0900	0900- 1100	1100- 1400	1400- 1700	1700- 2100	2100- 0000	2230- 0700 o/night
Mon	Monday 0600-0900	Monday 0900-1100	Monday 1100-1400	Monday 1400-1700	Monday 1700-2100	Monday 2100-0000	Monday 2230-0700 overnight

Tue	Tuesday 0600-0900	Tuesday 0900-1100	Tuesday 1100-1400	Tuesday 1400-1700	Tuesday 1700-2100	Tuesday 2100-0000	Tuesday 2230-0700 overnight

Wed	Wednesday 0600-0900	Wednesday 0900-1100	Wednesday 1100-1400	Wednesday 1400-1700	Wednesday 1700-2100	Wednesday 2100-0000	Wednesday 2230-0700 overnight

Thu	Thursday 0600-0900	Thursday 0900-1100	Thursday 1100-1400	Thursday 1400-1700	Thursday 1700-2100	Thursday 2100-0000	Thursday 2230-0700 overnight

Fri	Friday 0600-0900	Friday 0900-1100	Friday 1100-1400	Friday 1400-1700	Friday 1700-2100	Friday 2100-0000	Friday 2230-0700 overnight

Sat	Saturday 0600-0900	Saturday 0900-1100	Saturday 1100-1400	Saturday 1400-1700	Saturday 1700-2100	Saturday 2100-0000	Saturday 2230-0700 overnight

Sun	Sunday 0600-0900	Sunday 0900-1100	Sunday 1100-1400	Sunday 1400-1700	Sunday 1700-2100	Sunday 2100-0000	Sunday 2230-0700 overnight

Are you willing to work flexible hours?*
- Yes
- No
Are you willing to work 1 hour shifts?*
- Yes
- No
Are you willing to work overnight?*
- Yes
- No
Are you willing to work weekends?*
- Yes
- No
Are you willing to work at short notice?*
- Yes
- No
Are you prepared to travel 15-30 minutes for a 1 or 2 hour shift?*
- Yes
- No
How far are you prepared to travel?*
11. Upload your CV and cover letter
Please upload a PDF of your cover letter and resume. (PDFs can be saved/exported from Word and other text editors.) Maximum total file size 3MB only.
Upload file
Drop files here or

Accepted file types: pdf, Max. file size: 3 MB, Max. files: 3.
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Thanks in advance for applying to join the TraceCare team!

1. Regional availability

2. Contact details

3. Client safety

4. Citizenship and residency

5. Sector experience & suitability

6. Education & qualifications

Qualification 1

Qualification 2

Qualification 3

7. Employment history

Employer 1

Employer 2

Employer 3

8. References

Referee 1

Referee 2

Referee 3

9. Work type

10. Availability

11. Upload your CV and cover letter

We’d love to hear from you