First Name: Surname: Address: Post Code: Home Phone: Work Phone: Mobile: Fax: Email: Date of Birth: Country of Birth: Are you an Australian citizen?: Yes No (if no please state current status) Are you a registered childcare provider?: Yes No If yes what is your CRN?: (if no you will be required to register as a childcare provider) Marital Status: Single Married De Facto Religion: Any days you can't work due to religious reasons?: Yes No If yes please state: Can you please attach a copy of your CV: Can you please attach a photo of yourself:
Do you smoke?: Yes No Are you athletic?: Yes No Can you swim?: Yes No Can you speak any additional languages fluently?: Yes No If yes please state:
Do you have a current drivers licence?: Yes No If yes which state?: Type of licence?: Licence number?: Expire Date?: Have you had any driving convictions or violations in the past 3 years?: Yes No If yes please state:
How may years have you worked as a child carer?: Describe your experience as a child carer?: Why would you want to be a child carer?: What can you provide to a family that another child carer can't provide?: What ages have you had experience with?: (Other then your own children) Newborns 6-24 months 2-5 years 6-12 years Teenagers Have you had experience caring for the following?: Cared for twins/triplets Organized & played games with children Take children out on outings Put newborns onto a scheduled Cared for sick or injured children Attend to children's housekeeping Given medication Planned activities and outings Helped with housework Worked with parents 50/50 Sole charge Worked while parents are around Taken children to doctors/hospitals Have you cared for children with special needs or disabilities?: Yes No If yes please explain?:
Care for Kidz must be able to contact enough employers to account for and verify three years of experience. Employers name: Address: Phone Number: Date started: Date finished: Position held: Ages of children under your charge: Describe employment & duties: Reason for leaving: May we call them?: Yes No
Employers name: Address: Phone Number: Date started: Date finished: Position held: Ages of children under your charge: Describe employment & duties: Reason for leaving: May we call them?: Yes No
What year did you finish secondary education?: What was the highest level you attained?: Have you had any tertiary education?: Yes No If yes please state: Institution: Course Name: Duration: Year finished:
Institution: Course Name: Duration: Year finished:
Course: Year Completed:
How would you describe your health?: Excellent Good Average Poor How would you describe your energy level?: High Average Low Do you have any disabilities or handicaps that would prevent you from preforming specific tasks?: Yes No If yes please describe: Have you ever suffered or been treated for any emotional disorders? (eg depression, stress etc) Yes No If yes can you please provide details? Do you have any physical limitations?: Yes No If yes please state: Are you physically able to preform tasks of the position you are applying for?: Yes No Do you have any dietary restrictions?: Yes No If yes please state: Do you have any allergies?: Yes No If yes please state: Are you physically able to travel?: Domestically Yes No Internationally Yes No
Where would you prefer to work? Africa Asia Australia Europe North America South America Preferred location (eg: Brisbane, Sydney, London, New York etc.) Nanny position Mother's helper Before/after school care Babysitting Mummy Nanny Are you available for?: Live-in Live-out Full time Part time When are you available?: (please state hours on space provided) Monday: Tuesday: Wednesday: Thursday: Friday: Saturday: Sunday: What is the minium amount of hours you require?: Are you flexible?: Yes Maybe No Will you stay overnight if required?: Yes No Date of availability: Anticipated length of availability: (Care for Kidz has a minium 1-year commitment unless advised by the client) Salary/Wage range: Preferred age group you would like to work with?: Do you feel comfortable driving children around?: Yes No Do you feel comfortable to driving then in the family car if required?: Yes No Do you feel comfortable to drive children around in your car if required?: Yes No Are you able to travel with the family?: Yes No Do you have a valid passport?: Yes No How would you describe you personality and the type of person you are?: Please state your interests and hobbies:
Carers expectations of the family 1. Treat the carer with respect and in a professional manner. 2. Respect the hours, days, pay and days off outlined in the agreement/application form. 3. Communicate with the carer regarding changes of schedule days of work and job performance. 4. Support carer authority in setting time limits and behaviour with the children. 5. Provided a safe environment for the carers. 6. Respect the carers privacy outside the working environment as well as respect the carers personal life. 7. To provides funds for development games, art and craft, books, learning aids, outside activities and outings.
Family expectations of the carer 1. To provide a safe, caring, nurturing environment to the children. 2. To promote and meet the physical, emotional, social needs of the child/children. 3. Be reasonably flexible regarding emergencies and changes to family's schedule. 4. Be responsible, reliable, and punctual at the start of the day, and at appointments and activities. 5. Attend to all household duties relating to the children and work areas. 6. Fill out a daily nanny log regarding events throughout the day and report back to parents.
I the undersigned have filled in the application to the best of my knowledge to enable Care For Kidz to find suitable employment. I the undersigned has read, signed, dated and understood the Terms and Conditions set out by Care For Kidz and enclosed them with this application.
I also agree not to accept any jobs offers resulting from an interview without informing Care for Kidz or accept a job offered from a client directly or indirectly of Care for Kidz without speaking to Care for Kidz first. If I do I will be legally responsible for all fees that would be owed to Care for Kidz.
Carers Name: Address:
Before submitting, please be sure that all information you can enter is correct. If any necessary fields are left blank a Care for Kidz representative will be in touch as soon as possible to clarify.