Masonic Care WA's recruitment applications are hosted by external service providers who also recognise the importance of privacy. By proceeding with your application, you acknowledge that your personal information will be hosted by these external service providers until such time as you elect not to have your information stored on these external hosted sites.

1. Yes I agree to the privacy statement*

1. First name*
2. Last name*

1. E-mail*
2. Phone*

   Digits only or add + for international numbers

1. Street*
2. Street Cont.
3. City, Town or Suburb*
4. Postcode or Zipcode*
5. Country*Please choose... AFGHANISTAN ALBANIA ALGERIA AMERICAN SAMOA ANDORRA ANGOLA ANGUILLA ANTIGUA AND BARBUDA ARGENTINA ARMENIA ARUBA AUSTRALIA AUSTRIA AZERBAIJAN BAHAMAS BAHRAIN BANGLADESH BARBADOS BELARUS BELGIUM BELIZE BENIN BERMUDA BHUTAN BOLIVIA BOSNIA AND HERZEGOVINA BOTSWANA BRAZIL BRUNEI DARUSSALAM BULGARIA BURKINA FASO BURUNDI CAMBODIA CAMEROON CANADA CAPE VERDE CAYMAN ISLANDS CENTRAL AFRICAN REPUBLIC CHAD CHILE CHINA COLOMBIA COMOROS CONGO CONGO, THE DEMOCRATIC REPUBLIC OF THE COOK ISLANDS COSTA RICA COTE D'IVOIRE CROATIA CUBA CYPRUS CZECH REPUBLIC DENMARK DJIBOUTI DOMINICA DOMINICAN REPUBLIC ECUADOR EGYPT EL SALVADOR EQUATORIAL GUINEA ERITREA ESTONIA ETHIOPIA FALKLAND ISLANDS (MALVINAS) FAROE ISLANDS FIJI FINLAND FRANCE FRENCH GUIANA FRENCH POLYNESIA GABON GAMBIA GEORGIA GERMANY GHANA GIBRALTAR GREECE GREENLAND GRENADA GUADELOUPE GUAM GUATEMALA GUINEA GUINEA-BISSAU GUYANA HAITI HOLY SEE (VATICAN CITY STATE) HONDURAS HONG KONG SAR, CHINA HUNGARY ICELAND INDIA INDONESIA IRAN, ISLAMIC REPUBLIC OF IRAQ IRELAND ISRAEL ITALY JAMAICA JAPAN JORDAN KAZAKHSTAN KENYA KIRIBATI KOREA, DEMOCRATIC PEOPLE'S REPUBLIC OF KOREA, REPUBLIC OF KUWAIT KYRGYZSTAN LAO PEOPLE'S DEMOCRATIC REPUBLIC LATVIA LEBANON LESOTHO LIBERIA LIBYAN ARAB JAMAHIRIYA LIECHTENSTEIN LITHUANIA LUXEMBOURG MACAU SAR, CHINA MACEDONIA, THE FORMER YUGOSLAV REPUBLIC OF MADAGASCAR MALAWI MALAYSIA MALDIVES MALI MALTA MARSHALL ISLANDS MARTINIQUE MAURITANIA MAURITIUS MEXICO MICRONESIA, FEDERATED STATES OF MOLDOVA, REPUBLIC OF MONACO MONGOLIA MONTSERRAT MOROCCO MOZAMBIQUE MYANMAR NAMIBIA NAURU NEPAL NETHERLANDS NETHERLANDS ANTILLES NEW CALEDONIA NEW ZEALAND NICARAGUA NIGER NIGERIA NIUE NORFOLK ISLAND NORTHERN MARIANA ISLANDS NORWAY OMAN PAKISTAN PALAU PANAMA PAPUA NEW GUINEA PARAGUAY PERU PHILIPPINES PITCAIRN POLAND PORTUGAL PUERTO RICO QATAR REUNION ROMANIA RUSSIAN FEDERATION RWANDA SAINT HELENA SAINT KITTS AND NEVIS SAINT LUCIA SAINT PIERRE AND MIQUELON SAINT VINCENT AND THE GRENADINES SAMOA SAN MARINO SAO TOME AND PRINCIPE SAUDI ARABIA SENEGAL SEYCHELLES SIERRA LEONE SINGAPORE SLOVAKIA SLOVENIA SOLOMON ISLANDS SOMALIA SOUTH AFRICA SPAIN SRI LANKA SUDAN SURINAME SVALBARD AND JAN MAYEN SWAZILAND SWEDEN SWITZERLAND SYRIAN ARAB REPUBLIC TAIWAN, PROVINCE OF CHINA TAJIKISTAN TANZANIA, UNITED REPUBLIC OF THAILAND TOGO TOKELAU TONGA TRINIDAD AND TOBAGO TUNISIA TURKEY TURKMENISTAN TURKS AND CAICOS ISLANDS TUVALU UGANDA UKRAINE UNITED ARAB EMIRATES UNITED KINGDOM UNITED STATES URUGUAY UZBEKISTAN VANUATU VENEZUELA VIET NAM VIRGIN ISLANDS, BRITISH VIRGIN ISLANDS, U.S. WALLIS AND FUTUNA WESTERN SAHARA YEMEN ZAMBIA ZIMBABWE INTERNATIONAL OTHER Unknown
6. State, Region or Province*Please choose...

1. LinkedIn URL

   (Please click on your profile and copy the URL from your profile page.)

1. Please choose the option that best describes your right to work in Australia* Australian Citizen or Permanent Resident Temporary Resident/Visa holder I do not hold a visa or the right to work in Australia
2. If you hold a visa, what is your visa type? and are there any work limitations listed?
3. Have you ever previously been employed by Masonic Care WA?*

   1. Yes
   2. No
4. Which best describes your Qualifications:

   1. AHPRA Registration (Nursing)
   2. AHPRA Registration (Allied Health)
   3. Nursing Student - completed first 6 months
   4. Certificate 3 - Individual Support (Aged Care) or equivalent
   5. No qualifications - with experience
   6. No qualification - no experience
5. How many years of experience do you have?*

   1. None
   2. 0-2 years
   3. 2-5 years
   4. 5+ years
6. How many shifts/hours each fortnight would you be wanting to work? (approximate indication)* 8-10 shifts / 55 - 76 hours 5-7 shifts / 30 - 55 hours 3-4 shifts / 15 - 30 hours 1-2 shifts / 1 - 14 hours
7. What days are you available?*

   1. Monday - Morning
   2. Monday - Evening
   3. Monday - Night
   4. Tuesday - Morning
   5. Tuesday - Evening
   6. Tuesday - Night
   7. Wednesday - Morning
   8. Wednesday - Evening
   9. Wednesday - Night
   10. Thursday - Morning
   11. Thursday - Evening
   12. Thursday - Night
   13. Friday - Morning
   14. Friday - Evening
   15. Friday - Night
   16. Saturday - Morning
   17. Saturday - Evening
   18. Saturday - Night
   19. Sunday - Morning
   20. Sunday - Evening
   21. Sunday - Night
8. Pre-Employment Health Questionnaire Are you being treated by any doctor for illness or injury (work related or otherwise) or have you required time off work in the last 12 months?*

   1. Yes
   2. No
9. Do you have, or have you ever had, back, neck or shoulder problems?*

   1. Yes
   2. No
10. Are you willing to provide a medical clearance from your Doctor if required?*

    1. Yes
    2. No
11. Do you believe you are fit and physically able to fulfill all the duties required in the role applied for?*

    1. Yes - without any restrictions
    2. Yes - with some job modifications
    3. No
12. If you answered 'Yes - with some modifications' or 'No', what modifications (if any) would be required?
13. Pre employment requirements: Are you able to provide a National Police Clearance (less than 3 months old), your immunisation status for COVID-19 and Influenza, and appropriate evidence of your work rights in Australia? *

    1. Yes
    2. No
14. Do you have any convictions from any court, or charges pending before any court?*

    1. Yes
    2. No
15. Have you ever resigned or been terminated from a previous position due to poor performance or misconduct?*

    1. Yes
    2. No
16. Have you ever been included on the Aged Care Banning Register or been subject to any banning order that prevents you from working in aged care?*

    1. Yes
    2. No
17. I consent to Masonic Care WA retaining the personal information I have provided in my application.*

    1. Yes
    2. No
18. I declare that the information I have given is true to the best of my knowledge and belief. I have not made any false or misleading representations. I understand that If I have knowingly given information that is false, misleading or any omission of fault, could be cause for termination if employed.*

    1. Yes, I agree with the 'Declaration'

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