Returning Carer Form

Personal Details

First Name*
Please enter your first name.
Please enter your first name.
Last Name*
Please enter your last name.
Please enter your last name.
Email*
Please enter your email.
Please enter your email.

Date of Birth*

Day
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Please enter your date of birth
Please enter your date of birth
Month
  • - enter the month -
  • January
  • February
  • March
  • April
  • May
  • June
  • July
  • August
  • September
  • October
  • November
  • December
Please enter your date of birth
Please enter your date of birth
Year
Please enter your date of birth
Please enter your date of birth
Home Phone
Field is required!
Field is required!
Mobile Phone*
Please enter your mobile phone.
Please enter your mobile phone.
Street Address*
Please enter your street address.
Please enter your street address.
Suburb*
Please enter your suburb.
Please enter your suburb.
Postcode*
Please enter your postcode.
Please enter your postcode.
State*
  • - select an option -
  • VIC
  • QLD
  • NSW
  • ACT
  • TAS
  • SA
  • WA
  • NT
Please enter your state.
Please enter your state.

Emergency Contacts

Emergency Contact Name*
Please enter your emergency contact name.
Please enter your emergency contact name.
Emergency Contact Phone Number*
Please enter your emergency contact phone number.
Please enter your emergency contact phone number.
Emergency Contact Relationship*
Please enter your emergency contact relationship.
Please enter your emergency contact relationship.
Emergency Contact Name
Please enter your emergency contact name.
Please enter your emergency contact name.
Emergency Contact Phone Number
Field is required!
Field is required!
Emergency Contact Relationship
Please enter your emergency contact relationship.
Please enter your emergency contact relationship.

Drivers License

Do you have your own car?*
Please answer the question.
Please answer the question.
Car Registration
Please enter your car registration.
Please enter your car registration.
Drivers Licence Number
Please enter your drivers licence number.
Please enter your drivers licence number.
Upload a copy of your Drivers Licence
5MB max file size. Allowed file types: jpg, jpeg, png, gif, pdf, docx
Upload your documents...
Field is required!
Field is required!

Documents

Are you an Australian Citizen/Permanent Resident?*
Please answer the question.
Please answer the question.
Do you hold a current Australian Visa?*
Please answer the question.
Please answer the question.
If yes, What Visa are you on?
Field is required!
Field is required!

If yes, Visa Expiration Date

Day
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  • 31
Field is required!
Field is required!
Month
  • - enter the month -
  • January
  • February
  • March
  • April
  • May
  • June
  • July
  • August
  • September
  • October
  • November
  • December
Field is required!
Field is required!
Year
Field is required!
Field is required!
If yes, List any working restrictions (hours per week allowed to work)
Field is required!
Field is required!
If yes, Upload a copy of your Visa
5MB max file size. Allowed file types: jpg, jpeg, png, gif, pdf, docx
Upload your documents...
Field is required!
Field is required!
Do you have a Working With Children Check?*
Please answer the question.
Please answer the question.
If yes, WWCC Type
  • - select an option -
  • Employee
  • Volunteer
Please enter your WWCC type.
Please enter your WWCC type.
If yes, WWCC Number
Please enter your WWCC number.
Please enter your WWCC number.

If yes, WWCC Expiry Date

Day
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  • 31
Field is required!
Field is required!
Month
  • - enter the month -
  • January
  • February
  • March
  • April
  • May
  • June
  • July
  • August
  • September
  • October
  • November
  • December
Field is required!
Field is required!
Year
Field is required!
Field is required!
If yes, Upload a copy of your WWCC
5MB max file size. Allowed file types: jpg, jpeg, png, gif, pdf, docx
Upload your documents...
Field is required!
Field is required!
Have you ever been charged with a criminal offense?*
Please answer the question.
Please answer the question.
Do you have a Police Check?*
Please answer the question.
Please answer the question.

If yes, Police Check Date

Day
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  • 31
Field is required!
Field is required!
Month
  • - enter the month -
  • January
  • February
  • March
  • April
  • May
  • June
  • July
  • August
  • September
  • October
  • November
  • December
Field is required!
Field is required!
Year
Field is required!
Field is required!
If yes, Upload a copy of your Police Check
5MB max file size. Allowed file types: jpg, jpeg, png, gif, pdf, docx
Upload your documents...
Field is required!
Field is required!
First Aid Type*
  • - select an option -
  • HLTAID011 - Provide First Aid
  • HLTAID012 - Provide an Emergency First Aid Response in an Education and Care Setting
  • Other
  • None
Please enter your first aid type.
Please enter your first aid type.

If yes, First Aid Expiry Date

Day
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  • 31
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Field is required!
Month
  • - enter the month -
  • January
  • February
  • March
  • April
  • May
  • June
  • July
  • August
  • September
  • October
  • November
  • December
Field is required!
Field is required!
Year
Field is required!
Field is required!
If yes, Upload a copy of your First Aid Certificate
5MB max file size. Allowed file types: jpg, jpeg, png, gif, pdf, docx
Upload your documents...
Field is required!
Field is required!

Education

Qualification Type
  • - select an option -
  • VCE or Year 12 Equivalent
  • Early Years / Primary Teaching Degree
  • Primary Teaching Degree
  • Secondary Teaching Degree
  • Qualified OSHC Educator
  • Early Childhood Educator
  • International Nanny Certificate
  • International Childcare Certificate
  • Certificate III of Children's Services (Level Educator)
  • Certificate III of Early Childhood (Level Educator)
  • Diploma of Early Childhood (Level Educator)
  • Children's Therapist (Occupational, Speech Pathology, Psychology)
  • Qualified Nurse
  • Midwife/Mothercraft Nurse
  • Food Handling Certificate
  • Chef/Cook/Dietitian/Nutritionist
  • Medical Degree
  • Other
Field is required!
Field is required!
Qualification Information
Field is required!
Field is required!

Date Completed

Day
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  • 30
  • 31
Field is required!
Field is required!
Month
  • - enter the month -
  • January
  • February
  • March
  • April
  • May
  • June
  • July
  • August
  • September
  • October
  • November
  • December
Field is required!
Field is required!
Year
Field is required!
Field is required!
Upload a copy of your Qualification
5MB max file size. Allowed file types: jpg, jpeg, png, gif, pdf, docx
Upload your documents...
Field is required!
Field is required!
Qualification Type
  • - select an option -
  • VCE or Year 12 Equivalent
  • Early Years / Primary Teaching Degree
  • Primary Teaching Degree
  • Secondary Teaching Degree
  • Qualified OSHC Educator
  • Early Childhood Educator
  • International Nanny Certificate
  • International Childcare Certificate
  • Certificate III of Children's Services (Level Educator)
  • Certificate III of Early Childhood (Level Educator)
  • Diploma of Early Childhood (Level Educator)
  • Children's Therapist (Occupational, Speech Pathology, Psychology)
  • Qualified Nurse
  • Midwife/Mothercraft Nurse
  • Food Handling Certificate
  • Chef/Cook/Dietitian/Nutritionist
  • Medical Degree
  • Other
Field is required!
Field is required!
Qualification Information
Field is required!
Field is required!

Date Completed

Day
  • - enter the day -
  • 1
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  • 30
  • 31
Field is required!
Field is required!
Month
  • - enter the month -
  • January
  • February
  • March
  • April
  • May
  • June
  • July
  • August
  • September
  • October
  • November
  • December
Field is required!
Field is required!
Year
Field is required!
Field is required!
Upload a copy of your Qualification
5MB max file size. Allowed file types: jpg, jpeg, png, gif, pdf, docx
Upload your documents...
Field is required!
Field is required!
Qualification Type
  • - select an option -
  • VCE or Year 12 Equivalent
  • Early Years / Primary Teaching Degree
  • Primary Teaching Degree
  • Secondary Teaching Degree
  • Qualified OSHC Educator
  • Early Childhood Educator
  • International Nanny Certificate
  • International Childcare Certificate
  • Certificate III of Children's Services (Level Educator)
  • Certificate III of Early Childhood (Level Educator)
  • Diploma of Early Childhood (Level Educator)
  • Children's Therapist (Occupational, Speech Pathology, Psychology)
  • Qualified Nurse
  • Midwife/Mothercraft Nurse
  • Food Handling Certificate
  • Chef/Cook/Dietitian/Nutritionist
  • Medical Degree
  • Other
Field is required!
Field is required!
Qualification Information
Field is required!
Field is required!

Date Completed

Day
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  • 31
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Field is required!
Month
  • - enter the month -
  • January
  • February
  • March
  • April
  • May
  • June
  • July
  • August
  • September
  • October
  • November
  • December
Field is required!
Field is required!
Year
Field is required!
Field is required!
Upload a copy of your Qualification
5MB max file size. Allowed file types: jpg, jpeg, png, gif, pdf, docx
Upload your documents...
Field is required!
Field is required!

Experience

Have you had experience with any of the following? (tick more than 1 if needed)
Completing ALL fields in question below significantly assists our recruitment teams with your application.
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What age groups have you cared for?*
  • - select an option -
  • Newborns +
  • 3 months +
  • 6 months +
  • 9 months +
  • 12 months +
  • 18 months +
  • 2 years +
  • 3 years +
  • 4 years +
  • 5 years +
  • 8 years +
Please select an option.
Please select an option.
Cooking Skills*
  • - select an option -
  • None
  • Basic
  • Good
  • Excellent
Please select an option.
Please select an option.
Swimming Skills*
  • - select an option -
  • None
  • Average
  • Strong
Please select an option.
Please select an option.
Music Skills*
Please enter your music skills.
Please enter your music skills.
Languages*
Please enter your languages.
Please enter your languages.
Hobbies and Special Interests*
Please enter your hobbies.
Please enter your hobbies.
What animals do you dislike?
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Are you willing to do the following?
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Which of these tasks are you willing to carry out whilst on duty? (tick more than 1)*
Completing ALL fields in question below significantly assists our recruitment teams with your application.
Please select your tasks.
Please select your tasks.
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Which duties are you wishing to provide to Melbourne\'s Leading Nanny Agency clients? (tick more than 1 if needed)*
Completing ALL fields in question below significantly assists our recruitment teams with your application.
Please select your duties.
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Please select your duties.

Employment History

Referee 1

Your position held*
Please enter your position.
Please enter your position.

Start Date

Day
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Month
  • - enter the month -
  • January
  • February
  • March
  • April
  • May
  • June
  • July
  • August
  • September
  • October
  • November
  • December
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Year
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Finish Date

Day
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Month
  • - enter the month -
  • January
  • February
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  • April
  • May
  • June
  • July
  • August
  • September
  • October
  • November
  • December
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Year
Field is required!
Field is required!
Referee Name*
Please enter your referee\'s name.
Please enter your referee\'s name.
Referee Phone
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Field is required!
Referee Email
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Field is required!

Referee 2

Your position held
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Start Date

Day
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Month
  • - enter the month -
  • January
  • February
  • March
  • April
  • May
  • June
  • July
  • August
  • September
  • October
  • November
  • December
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Year
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Finish Date

Day
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Month
  • - enter the month -
  • January
  • February
  • March
  • April
  • May
  • June
  • July
  • August
  • September
  • October
  • November
  • December
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Year
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Referee Name
Field is required!
Field is required!
Referee Phone
Field is required!
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Referee Email
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Referee 3

Your position held
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Start Date

Day
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Month
  • - enter the month -
  • January
  • February
  • March
  • April
  • May
  • June
  • July
  • August
  • September
  • October
  • November
  • December
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Year
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Finish Date

Day
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Month
  • - enter the month -
  • January
  • February
  • March
  • April
  • May
  • June
  • July
  • August
  • September
  • October
  • November
  • December
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Year
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Referee Name
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Field is required!
Referee Phone
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Referee Email
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Field is required!
How would previous employers describe your personality?*
Please enter a description.
Please enter a description.

Availability and Confirmation

Monday
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Tuesday
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Wednesday
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Thursday
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Friday
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Saturday
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Sunday
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How far will you travel for placements (km)?*
Please enter your travel time.
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Details for any upcoming holiday or study plans
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Do you wish to be offered casual once off bookings and weekend babysits if they pop up around your area?*
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Would you be interested in Live in positions?*
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Would you be interested in Before & After school care roles?*
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Would you like to attach a Resume to your application? (PDF or Word Document)
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I confirm that all information provided is accurate and current, and I give my consent to Melbourne's Leading Nanny Agency and Australia's Leading Home Care Agency to contact my references.*
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