Medical Learning Support Officer

Job Title

Personal Details

Other

Given Name(s)

Surname

Address

Street and Suburb

State

Postcode

Country

Contact Details

Phone

Employment History

Please fill out the section below listing your current or most recent employer. You can also add other employment history as required. ‌

Employer/Company

Position Title

Address

Phone

Responsibilities (please add subjects taught – if applicable)

Start Date

Finish Date

2) Employer/Company

Position Title

Address

Telephone

Responsibilities (please add subjects taught – if applicable)

Start Date

Finish Date

3) Employer/Company

Position Title

Address

Telephone

Responsibilities (please add subjects taught - if applicable)

Start Date

Finish Date

+ Add employment history

Accreditations

Those applying for teaching positions are required to complete the fields below in relation to VIT and ability to teach in Catholic schools.

Those applying for non-teaching positions are only required to complete fields relating to the Working With Children Check (WWCC) and must hold, or be able to obtain a Victorian WWCC and National Police Check.

VIT number

VIT Expiry Date

Attach VIT Registration

Accreditation number

Attach Accreditation to teach Religious Education

Accreditation number

Attach Accreditation to teach in a Catholic school

Working With Children Check (WWCC) number – if held

Expiry

Attach Working With Children Check

Attach National Police Check – if held

Qualifications

Academic Qualifications (Secondary/Tertiary) including those for Religious Education.

Name of Institution

Year Completed

Attach Qualification

2) Name of Institution

Year Completed

Attach Qualification

3) Name of Institution

Year Completed

Attach Qualification

+ Add qualification

Other Qualifications

First Aid

Attach supporting document

CPR

Attach supporting document

Anaphylaxis

Attach supporting document

Asthma

Attach supporting document

Mandatory Reporting

Attach supporting document

Current Study

Name of School/College/University

Expected completion date

Interests

Professional memberships, parish, community, volunteer work, sporting involvement (if applicable)

Name of the Organisation

Position / Duties

Start date

Finish Date

On going

2) Name of the Organisation

Position / Duties

Start date

Finish Date

Ongoing

3) Name of the Organisation

Position / Duties

Start date

Finish Date

Ongoing

+ Add interest

Referee 1

Full name

Position

Phone

Business Phone

Relationship to Referee

Referee 2

Full name

Position

Phone

Business Phone

Relationship to Referee

Referee 3

Full name

Position

Phone

Business Phone

Relationship to Referee

+ Add referee

Proof of Identity

Please attach a copy of your photo identification, for example a Driver Licence or passport.

Proof of Identity

International Applicants

I have the right to work in Australia

Please attach copy of this authority

Pre-employment Disclosure Questions

It is an inherent requirement of the position that you be a person suitable to work with children. Each of the following questions are relevant to the prospective employer understanding and determining your likely ability to carry out the inherent requirements of the advertised position. You must answer each question.

1. Have you ever had any disciplinary action taken against you by an employer (e.g. received a warning or had your employment terminated) in relation to any inappropriate or unprofessional conduct?YesNo

If yes, please provide details.

2. Have you ever been the subject of an allegation of inappropriate or unprofessional conduct which has been substantiated by an employer or other body?YesNo

If yes, please provide details.

3. Have you ever been found guilty of a criminal offence or are you currently facing criminal charges?YesNo

If yes, please provide details

4. Have you been subjected to any investigation by an employer or any other bodyYesNo

If yes, please provide details

5. Do you consent to the prospective employer contacting the appropriate person at any or all of your current or former employers to confirm the accuracy of your answers in questions 1–4 above and to ask about your suitability to work with children?YesNo

If no, please provide details

Supporting Documents

Please upload doc or pdf format only. Please name file Surname, First name.

Covering Letter

Resume

**Please note that the personal/sensitive information provided by applicants is being collected by the College to assess each applicant’s suitability for the position and it is protected from misuse or disclosure. By submitting this application form you consent to this process.

Declaration

I declare that the contents of this form are true and correct and complete to the best of my knowledge and no information concerning my employment history has been withheld.

I understand that any wilfully incorrect or misleading answer or material omission which relates to any of the questions in this form may make me ineligible for employment, or if employed, liable to disciplinary action which may include dismissal.

I understand that all applicants are required to undergo background screening which may include a National Police Record Check. I consent to such screening and checks in connection with my application for employment. I consent to the prospective employer making inquiries of any current and/or previous employers in connection to the information and answers I have provided in this form to verify the accuracy of the information in this form and to confirm my ability to carry out the inherent requirements of the position including my suitability to perform child-connected work. I understand and accept that my appointment to this position requires compliance with the school’s child-safe policy and code of conduct. I have read and understand the school’s child-safe policy and code of conduct.

I understand and accept that my appointment to this position requires a commitment to Catholic Education. I have read and understand the Statement of Principles regarding Catholic Education.

I acknowledge that I have received a copy of the Employment Collection Notice.

Signature

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Personal Details

Address

Contact Details

Employment History

Accreditations

Qualifications

Other Qualifications

Current Study

Interests

Referee 1

Referee 2

Referee 3

Proof of Identity

International Applicants

Pre-employment Disclosure Questions

Supporting Documents

Declaration