Register Interest for a Non Teaching Position

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The Department of Education through Western Cape College is collecting personal information in accordance with Education (General Provisions) Act 2006 in order to register interest for a position. The information will only be accessed by employees of the Department of Education. The information will not be given to any other person or agency unless prior consent is obtained.

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Title *

Surname *

Given name *

Preferred name

State *

Postcode *

Postal address

Postal state

Postal postcode

Previous surname (if applicable)

Date of birth *

Primary phone *

Alternative contact number

Email address *

Have you ever been employed with Western Cape College? *

Yes

No

Outline your reasons for applying to work at Western Cape College.

Do you hold a current Suitability Card? *

Yes

No

If yes, please provide the Suitability Card number and expiry date.

Are you an Australia citizen or a permanent resident of Australia? *

Yes

No

Are you currently on leave from any Commonwealth, State government department or private sector organisation? If yes, please provide a statement giving details. *

Your present employer and position

Your present work status

Full time

Part time

Term time

Contract

Your present position period (from/to)

Your previous employment history

Please provide the information of the employer name, position held, work status, (e.g. permanent, temporary, relief), dates (from/to), line manager.

Relevant qualifications

Qualification, name of institution, course completion date/year.

Professional referee 1 *

Full name, position/organisation, contact numbers.

Professional referee 2 *

Full name, position/organisation, contact numbers.

Professional referee 3 *

Full name, position/organisation, contact numbers.

Outside activities, hobbies, interests

Is your present employer aware of this application/enquiry?

Yes

No

Not applicable

By what date would you be able to take up a new appointment? *

Do you have a known health condition which could prevent you from competently and efficiently carrying out the duties of this position in a manner which is safe to yourself, your co-workers, the public and Western Cape College? *

If yes, please provide details.

Applicant's declaration *

Yes

I certify that the information contained in this application is a true and correct statement of my particulars, qualification, training, experience and competencies. I understand that statements found to be false within my knowledge may make me liable for immediate dismissal.

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