Agency Registration - Lisa's Staffing Solutions

First Name

Last Name

Date of Birth (dd/mm/yyyy)

Birthplace

Marital Status

Partners Name (if applicable)

Do you have children?

Yes

No

Children's Ages

Email

Home Phone

Mobile Phone

Home Address

Address

City

State

Postcode

Preferred method of contact:

Home Phone

Mobile Phone

Email

Next of Kin/Emergency Contact

Full Name

Relationship

Home Phone

Mobile Phone

Next of Kin Email

Home Address

Address

City

State

Postcode

Do you have a drivers license?

Yes

No

Driver's License Type/Number

Auto/Manual

Auto

Manual

Do you have your own car?

Yes

No

Car Registration

Car Model

Have you ever had your drivers license suspended? If yes, give details.

Are you an Australian citizen?

Yes

No

If no, do you hold a current Australian Visa?

Yes

No

Work Visa Details

Does your Australian Visa have more than 12 months remaining?

Yes

No

Passport Number

Passport Country of Issue

Have you ever been convicted of a criminal offence?

Yes

No

If yes, please provide details. (Police Check Number)

Do you have a current Working With Children's Check?

Yes

No

Working With Children's Check Number

Working With Children's Check Expiry (dd/mm/yyyy)

Have you noted Lisa’s Staffing Solutions as an employer on your WWC?

Yes

No

If you do not have your Working With Children Check you can apply for it here.

First Aid Type

Expiry Date (dd/mm/yyyy)

First Aid Courses

HLTAID003 - Provide First Aid

HLTAID004 - Provide an Emergency First Aid Response

Do you have a degree?

Yes

No

Where did you complete your degree?

Title of your degree?

Other qualifications?

Cooking Skills

Kosher Experience

Yes

No

Swimming Skills

Music Skills

Languages

Hobbies

Are you a smoker?

Yes

No

Please upload copies of the following:

Passport

Choose File

Resume

Choose File

Working With Children Check

Choose File

First Aid Certificate

Choose File

Photo of Yourself

Choose File

Drivers License

Choose File

Medicare Card

Choose File

Police Check

Choose File

Certificates/Qualifications

Choose File

Please download and complete the following forms and then upload here.

Code of Conduct

Choose File

Health Declaration

Choose File

Registration Form

Choose File

Please complete the following training:

Mandatory Reporting eLearning Module

ACCESS TRAINING

(https://elearn.childlink.com.au/login/index.php)

COVID-19

Have you been fully vaccinated against COVID-19?

Yes, triple vaccinated (booster shot).

Yes, double vaccinated.

Single vaccine only.

No, I have a medical exemption.

I prefer not to say

Please provide proof of vaccination or medical exemption.

Choose File

Reference checks

Please list 3 references.

How did you hear about us?

Do you know anyone who has or is currently working for Lisa's Staffing Solutions?

Is there anything else we need to know?

Register to join our agency!

Next of Kin/Emergency Contact

Please upload copies of the following:

Please download and complete the following forms and then upload here.

Please complete the following training:

Mandatory Reporting eLearning Module

COVID-19

Reference checks

If you have any questions please email us at:

[email protected]