Client Profile form
Full Name
Email Address
Phone Number
Which of the following types of support are you able to complete?
Individual Support
After School Care
Holiday Program
Support in Groups
Support at Pandanus House
Support in the Participant’s home
Support in your own home
Overnight support
Please advise the days of the week you are able to work (generally):
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Are you able to work early mornings on any of the following days?
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Are you able to work late afternoons/evenings on any of the following days?
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Are you able to work overnight on any of the following days?
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Please provide any other information relevant to the days and times you are available to work:
Are you interested in being a Team Leader on group programs?
Yes
No
Do you have a preferred work location or region? (please note - due to client needs, we may not always be able to accommodate these preferences)
Are you prepared to transport participants in your own vehicle?
Yes
No
Are you prepared to transport participants in an Inclusion Plus vehicle? (please note – driver training will be provided)
Yes
No
Is there any other information you would like to provide about your availability?
Submit
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