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Home
About BNA
Services
Open menu
Personal Care Assistants (PCA)
Enrolled Nurses (EEN)
Registered Nurses (RN)
Food Service Attendants
Skilled Chefs
Environmental Services
Resources
Open menu
Blogs
Contact Us
Call Now
Call Now
Home
About BNA
Services
Open menu
Personal Care Assistants (PCA)
Enrolled Nurses (EEN)
Registered Nurses (RN)
Food Service Attendants
Skilled Chefs
Environmental Services
Resources
Open menu
Blogs
Contact Us
Menu
Home
About BNA
Services
Open menu
Personal Care Assistants (PCA)
Enrolled Nurses (EEN)
Registered Nurses (RN)
Food Service Attendants
Skilled Chefs
Environmental Services
Resources
Open menu
Blogs
Contact Us
PCA
Please enable JavaScript in your browser to complete this form.
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Step
1
of 7
Personal Information
Title
Dr.
Mr.
Mrs.
Miss.
Ms.
Prof.
First Name
*
Middle Name
*
Last Name
*
Gender
*
DOB
*
Mobile
*
Email address
*
Attach your Photo
Address Information
Unit No.
*
Street No
*
Street Name
Suburb
*
State
*
Postcode
*
Residential Status:
*
Australian Citizen
Australian Permanent Resident
Working Visa
Temporary Resident Visa
Student Visa
Next
Primary Documents
Attach Passport image
Or
Attach Birth certificate
Secondary Documents
Attach Driving Licence
Or
Attach Working with children certificate
Or
Attach Student ID
Or
Attach Australian Citizenship certificate
Or
Attach Australian Medicare card
Photo ID
Attach Passport image
or
Attach Driving Licence
Next
Emergency Contact Information
Full Name
*
Relationship
Mobile Phone Number
*
Home Phone Number
Referee 1 Information
Referee 1 Name
*
Referee 1 CompanyName
*
Referee 1 Position
*
Referee 1 Relationship
*
*Referee 1 Mobile
*
Referee 2 Information
Referee 2 Name
*
Referee 2 CompanyName
*
Referee 2 Position
*
Referee 2 Relationship
*
Referee 2 Mobile
*
Bank Account Information
Account Name
*
Bank Name
*
BSB
*
Account Number
*
Next
Tax File Number Declaration Information
Tax File Number
*
On what basis are you paid?
Full-time employment
Part-time employment
Labour hire
Superannuation or annuity income stream
Casual employment
Are you:
*
An Australian resident for tax purposes
A foreign resident for tax purposes
A working holiday maker
Do you want to claim the tax-free threshold from this payer?
Only claim the tax‑free threshold from one payer at a time, unless your total income from all sources for the financial year will be less than the tax‑free threshold.
Yes
No
Answer no here if you are a foreign resident or working holiday maker, except if you are a foreign resident in receipt of an Australian Government pension or allowance.
Do you have a Higher Education Loan Program (HELP), VET Student Loan (VSL), Financial Supplement (FS), Student Start-up Loan (SSL) or Trade Support Loan (TSL) debt?
Yes
No
Your payer will withhold additional amounts to cover any compulsory Yes repayment that may be raised on your notice of assessment.
Super Fund Information
DO YOU HAVE OWN SUPER ACCOUNT
Yes
No
Super Account Name
Super Fund Name
Super Membership Number
Super Fund Address
Super Phone No
*
Super Website
*
Super Fund ABN
*
Super Fund USI
*
Next
Police Check Information
Attach Australian Police Clearance certificate
Transcript
Attach transcript outlining the units completed
*
Mandatory Competencies and Training
Attach Qualifications certification such as Certificate III in Aged Care OR Bachelor of Nursing
Attach AHPRA registration number (Nurses only)
Attach Up to date vaccinations (Flu)
Attach Up to date vaccinations (COVID)
What is your main method of transport?
Car
Public Transport
*How far are you prepared to travel for work?
Next
Medical History
To assist us to comply with our obligation to ensure a safe workplace and in order to enable us to determine whether applicants are able to safely and adequately perform duties required by the position, please provide details of any previous or current injuries, illnesses or disabilities of which you are aware and which you believe may affect your ability to carry out the requirements of the position. (Victoria only: Failure to provide such information may constitute a breach of section 82(7) of the Accident Compensation Act 1985(Vic) and according to section 82(3) of the Act may result in any aggravation etc of the injury arising out of the employment not qualifying for compensation under legislation.)
Flu Vax
Y
N
Do you have any physical disabilities, medical conditions or previous injuries which may affect your ability to perform your work duties?
Yes
No
If yes please give details:
Do you have an intellectual disability that may affect your ability to perform your work duties?
Yes
No
If yes please give details:
VACCINATIONS: Please select the appropriate box for the below vaccinations
COVID Vax
Y
N
Have you previously been injured at work? Y/N
Yes
No
If yes please give details:
Are you currently receiving any medical attention from a doctor or anyone else? If so, please give details
Yes
No
If yes please give details:
Have you ever experienced or been treated for any of the following conditions?
Eye Trouble
YES
NO
Hearing Impairment
YES
NO
Surgical Procedures
YES
NO
Asthma
YES
NO
Hernia
YES
NO
Duodenal Ulcer
YES
NO
Deafness
YES
NO
Lung Disorder
YES
NO
Fainting/Blackout
YES
NO
Back trouble/disorder
YES
NO
Nerve Disorders
YES
NO
Dizziness
YES
NO
Arthritis
YES
NO
Swollen Joints
YES
NO
Chronic Illnesses
YES
NO
Skin Trouble
YES
NO
Diabetes
YES
NO
Injury (any body part) give details:
YES
NO
Please Provide Details
AUTHORITY TO REPRESENT
What your personal information is: Personal information is any information or an opinion (whether true or not) about you. It may range from the very sensitive (e.g., medical history or condition) to the everyday (e.g., address and phone number). It would include the opinions of others about your work performance (whether true or not), your work experience and qualifications, aptitude test results, and other information obtained by us in connection with your possible work placements. Who will be collecting your personal information? Your personal information will be collected by BNA and used to assist us in determining your suitability for work placements. If you wish to contact us about your personal or sensitive information, you should contact us during normal business hours, which are 8:30 am to 5:30 pm. How your information will be collected: Personal information will be collected from you directly when you fill out and submit one of our registration forms or any other information in connection with your application to us for registration. Personal information will also be collected when: we receive any reference about you - we receive the results of any competency or medical test - we receive performance feedback (whether positive or negative) - we receive any complaint from or about you in the workplace - we receive any information about a workplace accident in which you are involved - we receive any information about any insurance investigation, litigation, registration or professional disciplinary matter, criminal matter, inquest or inquiry in which you are involved - you provide us with any additional information about you Your information will be used: Your personal information may be used in connection with: - your actual or possible work placement - your performance appraisals - our assessment of your ongoing performance and prospects - any test or assessment (including medical tests and assessments) that you might be required to undergo - our identification of your training needs - any workplace rehabilitation - our management of any complaint, investigation or inquiry in which you are involved - any insurance claim or proposal that requires disclosure of your personal information Your personal information may be disclosed to: - potential and actual employers and clients of BNA - referees - other member organizations of BNA - our insurers - a professional association or registration body that has a proper interest in the disclosure of your personal information - a workers' compensation body - our contractors and suppliers (e.g., IT contractors and database designers) - any person with a lawful entitlement to obtain the information You can gain access to your personal information that we hold: Under privacy legislation, you have a right to see any personal information about you that we may hold. If you are able to establish that any of the information that we hold about you is not accurate, complete, and up to date, we will take reasonable steps to correct this. Storage and Security BNA take all reasonable steps to ensure that information held in paper or electronic form is secure, and that it is protected from misuse, loss, unauthorized access, modification, or disclosure. All staff at BNA will take reasonable steps to ensure that personal information is only used for recruitment purposes or disclosed to other organizations to the extent necessary for our business purposes. When personal information is no longer required, it will be destroyed. I have read the above and understand that BNA will collect my personal information and use this in order to represent me to potential and actual employers and clients for the purposes of finding me work placements.
Checkboxes
*
I HAVE READ AND UNDERSTOOD THE ABOVE PRIVACY POLICY.
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