Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Date of application {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Mobile Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Current place of study (University/College) {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Qualification currently studying {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Tutor details
Tutor name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Tutor Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Tutor Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
Total number of work placement hours required {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Preferred starting date for your work placement {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Please provide details as to why you wish to complete your work placement with Community Living Australia {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Driver's licence details
Driver's Licence Number {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Driver's Licence Type {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Driver's Licence Expiry Date {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Please provide details of restriction: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
Do you hold any of the following
{ binding firstError.message }
Where did you hear about work placement opportunities with us? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Where did you hear about us? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
Shift Availability (please tick all shifts you are available to work)
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
Please attach a copy of the following documents (if available)
Work placement insurance documents from your University/College {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Workplace Agreement from your University/College {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Current DHS Disability services Employment Screening {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Current DHS Child Related or Working with Children Check {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Current Driver's Licence {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Current First Aid Certificate {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Current CPR Certificate {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Child Safe Environments Certificate {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
Declaration by Applicant
{ binding firstError.message }
Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Date {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }