Educator Application Form

Family Day Care Educator - Application Form

Section 1 - Applicant's Details

Surname(*)

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Given Name(*)

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Date of Birth(*)

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Gender(*)

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Residential Address(*)

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State(*)

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Postcode(*)

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Are you renting the property?(*)

YesNo

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Home Number

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Mobile Number(*)

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Email(*)

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Ethnic Origin(*)

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Section 2 - Your Partner's Details

Surname

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Given Name

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Date of Birth

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Ethnic Origin

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Gender

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Work / Study

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Occupation

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Hours of Work

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Home Number

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Mobile Number

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Section 3 - Details of Children Living at Home

1. Child's Full Name

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Gender

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Date of Birth

/ / Invalid Input

Hours at Home

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School Attending

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Immunised?

YesNo Invalid Input

2. Child's Full Name

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Gender

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Date of Birth

/ / Invalid Input

Hours at Home

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School Attending

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Immunised?

YesNo Invalid Input

3. Child's Full Name

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Gender

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Date of Birth

/ / Invalid Input

Hours at Home

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School Attending

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Immunised?

YesNo Invalid Input

4. Child's Full Name

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Gender

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Date of Birth

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Hours at Home

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School Attending

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Immunised?

YesNo Invalid Input

Section 4 - Details of other adults in the home

1. Full Name

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Age

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Relationship to you

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Hours at home

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2. Full Name

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Age

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Relationship to you

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Hours at home

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Section 5 - Employment History

Please provide a summary of your employment background, commencing with your most recent position. Please also attach your resume to this application form.

Upload Resume(*)

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Positions Held

1. Organisation(*)

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Position(*)

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Description of Main Duties and Responsibilities(*)

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Date Commenced(*)

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Click on month to set calendar

Date Completed(*)

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Click on month to set calendar

2. Organisation(*)

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Position(*)

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Description of Main Duties and Responsibilities(*)

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Date Commenced(*)

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Click on month to set calendar

Date Completed(*)

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Click on month to set calendar

How many years experience do you have in the Childcare sector?(*)

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Section 6 - Qualifications

Please list your qualifications relevant to childcare / education:(*)

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Please list any other courses / qualifications that you are currently undertaking:(*)

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Do you hold any of the following certificates?

HLTAID004 - Provide an emergency first aid response in an education and care setting(*)

YesNo

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Expiry Date

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CHCCHILD401B - Identify and respond to children and young people at risk (*)

YesNo

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Expiry Date

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Current paid Working With Children Check clearance(*)

YesNo

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Expiry Date

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Section 8 - Questions

Please explain why you wish to become a Family Day Care Educator:(*)

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Please outline your experience, how it is relevant and why you are suited to the role of an Educator:(*)

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What would you regard as your strengths that would contribute to this role:(*)

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Please tell us about your communication skills, both written and verbal relevant to working with children and families:(*)

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Please explain what you know about how children learn and develop:(*)

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Briefly list the types of activities and experiences you would provide children in care:(*)

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Have you ever run a business? How competent do you feel with managing administration tasks and computer skills?(*)

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Section 9 - Availability

What days of the week and hours each day would you prefer to work in Family Day Care?

Hours(*)

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Section 10 - Referee Details

Please list the details of two referees who can be contacted to provide either employment or character references (not a relative).

1. Full Name(*)

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Phone(*)

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Occupation(*)

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Relationship to you(*)

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2. Full Name(*)

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Phone(*)

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Occupation(*)

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Relationship to you(*)

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I acknowledge that the personal information provided on this application is collected for the purpose of applying to be an approved Educator with Bathurst Family Day Care. Access is limited to use by Family Day Care employees and other authorised persons. Supply of the personal information is mandatory and non-supply could cause inability or delay the ability to process this application. The personal information will be stored in the Bathurst Family Day Care records system.

Applicant's Name(*)

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Applicant's Initials(*)

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Date of Application(*)

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For security please complete(*)

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