Trial HSC Trial Exam Supervisor Form

Trial HSC Exam Supervisor

Trial HSC Trial Exam Supervisor

Trial HSC Trial Exam Supervisor Form

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Trial HSC Trial Exam Supervisor Form

EDMUND RICE COLLEGE

Trial HSC Trial Exam Supervisor Form

Please complete the ‘Trial HSC Trial Exam Supervisor Form’ to apply for placement at Edmund Rice College.

Please ensure all information is correct and up to date. If at any stage you need to stop completing the application before submission, please use the “save and continue” button at the bottom of the form.

For further enquiries, please contact the Director of Professional Services via jthomas@erc.nsw.edu.au or on (02) 4228 4344.

Trial HSC Trial Exam Supervisor Form

Position Type:(Required)

Trial HSC Supervisor

Start date:(Required)

DD slash MM slash YYYY

Personal Details

Title (Mr, Mrs, Ms, Miss, Dr):(Required)

Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Phone(Required)

Email:(Required)

Date of Birth:(Required)

DD slash MM slash YYYY

Emergency Contact

Name(Required)

First Last

Relationship(Required)

Phone(Required)

Working With Children Check (WWCC)

This position is child-related work; you must obtain a Working with Children Check Clearance number from ServiceNSW. You are not permitted to provide services at Edmund Rice College until you provide the College with your WWCC number and it has been verified.

Do you hold a WWCC?(Required)

Yes

WWCC number:(Required)

Application number:

Date of application:

DD slash MM slash YYYY

Health & Employment

Applicants are asked to complete all of the 'Health & Employment Declaration' and to provide any supporting or explanatory material. The information is necessary in order to assess each applicant’s eligibility. This information is confidential. If the space below is sufficient, please attach separate documentation.

Do you have any current health problems, which may impact on your capacity to carry out the duties of a contractor at Edmund Rice College?(Required)

Yes

Please provide details:(Required)

Are you taking regular medication prescribed by a medical practitioner, which may impact on your capacity to carry out the duties of a contractor at Edmund Rice College?(Required)

Yes

Please provide details:(Required)

Health & Employment Declaration(Required)

By submitting this application, I am agreeing to the following:

(1) I understand that if further medical information is required, I may be asked to give written authorisation for Edmund Rice College to seek medical information.
(2) I acknowledge that all information provided in support of these responses are true and correct in every respect, and any wilful suppression or inaccuracy may result in non-acceptance of this application and/or termination of services.

Child Protection & Professional Conduct

Have you ever been accused of physically, sexually or emotionally abusing a child or a young person?(Required)

Yes

Please provide details:(Required)

Have you ever been the subject of an allegation of ‘reportable conduct’ (that is: sexual offence, sexual misconduct, assault, ill-treatment, neglect or psychological harm of a child or young person) as defined by the NSW Office of Children's Guardian?(Required)

Yes

Please provide details:(Required)

Have you ever been the subject of a complaint/allegation and/or internal investigation that related to a breach of your professional boundaries and/or breach of a Code of Conduct?(Required)

Yes

Please provide details:(Required)

Are you aware of any reason or concern, held by another person, which may make you unsuitable to work in child-related employment?(Required)

Yes

Please provide details:(Required)

Have you ever been the subject of an Apprehended Violence Order (AVO) that was made for the purpose of protecting a child or young person from harm?(Required)

Yes

Please provide details:(Required)

Have you ever been charged and/or convicted with any criminal offence?(Required)

Yes

Please provide details:(Required)

Are you a parent or close relative of a student currently enrolled at Edmund Rice College?(Required)

Yes

Please provide details:(Required)

Proof of Identity

Identification Documents (Drivers Licence / NSW Government Photo Identification Card)(Required)

Drivers Licence / NSW Government Photo Identification Card

Identification Documents (Birth Certificate / Passport)(Required)

Birth certificate / Passport

Identification Documents (Medicare Card)(Required)

Medicare card

File Upload(Required)

Drop files here or

Max. file size: 512 MB.

Please upload your 3 IDENTIFICATION DOCUMENTS.

APPLICANT DECLARATION

Consent(Required)

By submitting this application, I am agreeing to the following::

(1) There is no reason for Edmund RIce College to believe I am not suitable to provide services in child-related work. If any information not disclosed in this application is brought to the attention of the College, my application may be reviewed and/or services may be terminated.
(2) I am aware of my obligations under the Child Protection (Working with Children) Act 2012 to notify the College of any changes to my Working with Children Check Number status or to any change to my personal circumstances that would preclude providing services in child related work.
(3) The information provided in this application form is complete and correct in every detail, and I understand that deliberate inaccuracies or omissions may result in non-acceptance of my application and/or termination of services.
(4) I agree to respect, support and uphold the mission, ethos and teachings of the Catholic Church and the values of Edmund Rice College.
(5) I agree to complete all necessary Edmund Rice College compliance modules prior to providing services at the College.

Date(Required)

DD slash MM slash YYYY

Name(Required)

First Last

Signature(Required)

Visit Us

Address

Email

Phone

Fax

Hours

Trial HSC Exam Supervisor

Trial HSC Trial Exam Supervisor

Trial HSC Trial Exam Supervisor Form

Trial HSC Trial Exam Supervisor Form

Trial HSC Trial Exam Supervisor Form

Trial HSC Trial Exam Supervisor Form

Trial HSC Trial Exam Supervisor Form

EDMUND RICE COLLEGE

Trial HSC Trial Exam Supervisor Form

Trial HSC Trial Exam Supervisor Form

Personal Details

Emergency Contact

Working With Children Check (WWCC)

Health & Employment

Child Protection & Professional Conduct

Proof of Identity

APPLICANT DECLARATION