Interview Form Home Care Cleaner Name(Required) First Last Gender(Required) Male Female Other Email(Required) Phone(Required)Suburb/Postal Code(Required) City ZIP / Postal Code Tell Me About Yourself(Required)Quick Employment QuestionsAre you an Australian/New Zealand Citizen? If no, go to next question(Required) Yes No Do you have the right to work in Australia? If no, please email a copy of your Visa to [email protected]. Yes Do you have a?(Required) Reliable Car Police Check (Must be completed in last 6 weeks) Working with Children Check First Aid Certificate NDIS Worker Screening Check CPR Certificate Experience QuestionsHave you worked as a professional cleaner before?(Required) Yes No If yes, please give detailsDomestic Assistance – Have you provided domestic tasks to aged and elderly clients?(Required) Yes No If yes, please give detailsHave you provided domestic tasks to clients that fit any of the below:(Required) Dementia/Alzheimers Brain Injury Care Disability Care Mental Health Autism Experience Vision Impairment End of Life None of the above What training and certifications have you completed?Have you completed any training specific to this industry?Do you speak any languages other than English?What days are you available?(Required) Monday Tuesday Wednesday Thursday Friday Saturday Sunday What times are you available?(Required)E.G. 9.00AM – 3.00PMHow many hours a week would you like to receive?(Required) 0 – 5 hours 5 – 10 hours 10 – 20 hours 20 – 30 hours 30+ hours Notes
