All fields marked with an asterisk (*) are required Job Application Form HiddenJob ID HiddenJob Title Applicant DetailsTitle*MrMrsMissMsDrFirst Name* Surname* Address* Street Address Address Line 2 City State Post Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Contact DetailsWorkHomeMobile*Email* Experience*Qualification/sYear Qualification/s Obtained Are you an Australian Citizen / Permanent Resident?* Yes No Do you have a current working visa?* Yes No ORIGINAL work visa or permanent residency status must be presented at interviewAre you of Aboriginal or Torres Strait Islander descent?* Yes No Do You have a current National Police check? Yes No Do you hold a current Australian Drivers Licence?* Yes No Do you require any special arrangements at an interview?* Yes No Have you had a flu vaccination this year?* Yes No Please provide details*Are you aware of any pre-existing injury or disease that you could reasonably be expected to foresee, that could be affected by the nature of the duties and responsibilities of the position for which you are applying?* Yes No Please provide a brief description (or on a separate advice)*(Note: failure to disclose or making a false or misleading disclosure may impact on your right to compensation under the Workplace Injury Rehabilitation and Compensation Act 2013) YDHS may request a pre-employment medical examinationDo you have any convictions, finding of guilt and/or pending police charges against you that are less than 10 years old?* Yes No You must provide a National Police Record Check prior to commencing work. This must be 3 years or less from date of issue.Please provide brief detail*Employment DetailsAre you an existing staff member?* Yes No Position Ttitle* Area* Are you currently employed?* Yes No How long have you been with this employer?* How many hours per week do you work?* Is your current employer in the Health Services Industry?* Yes No If yes, you may be entitled to transfer entitlementsLong Service Leave Entitlement* Yes No Upload your Resumé*Accepted file types: pdf, Max. file size: 128 MB.Please use a PDFUpload your Cover Letter*Accepted file types: pdf, Max. file size: 128 MB.Additional documents Drop files here or Select files Accepted file types: pdf, Max. file size: 8 MB. Use a PDFCAPTCHA