Little Champs Sports Club Staff Application Form (Page 2 of 3) in pdf

Little Champs Sports Club Staff Application Form Page 2

Staff Application

3.) Health

It is our obligation to ensure that you are not placed in a position of employment that may be

detrimental to your health and well-being. Please answer the following questions taking into

consideration the nature of the work associated with the position for which you are applying.

As part of the selection process you may be required to undergo a pre-employment health

assessment by a Medical Practitioner/ Health Service provider of our choice.

a.) Please list details of any pre-existing illnesses or injuries that may be affected by the nature of

the work:

b.) If you have pre-existing conditions as per section 3.a please provide details how this will

affect you as you carry out your duties:

c.) List details of previous workers compensation claims made in relation to illnesses, conditions,

injuries, etc that may be affected by the nature of the work:

d.) Date of claim:

e.) Date claim finalised:

f.) Are there any other facts, limitations or problems of which we should be aware which may

impact on your ability to perform your role in a satisfactory manner?

YES (please provide details)

4.) Position

a.) Position applying for:

b.) What are your reasons for seeking a position with Little Champs Sports Club?

c.) Please list any areas of expertise and experience that relate directly to the Position Description:

d.) Are there any particular interests or abilities that would enhance your contribution to this

position?

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Little Champs Sports Club| Application Form 2014 .au|

0421348036

Little Champs Sports Club Staff Application Form Page 2