Helping Hands Support Work

New Employee Intake Form

Part One: Employee Details

First Name *

Last Name *

Date of Birth *

Mobile Number *

Email Address *

Residential Address *

Street address *

City *

State *

Postcode *

About You *Please provide a good amount of detail here - this information will be used to promote our services to potential clients.

ID Photo *

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Please use the following file upload function to upload a clear photo of yourself. Please ensure the photo is clear, with you looking straight forward, including full face and shoulders and without filters.

Do you consent to Helping Hands Support Work Pty Ltd using your photo for promotional materials (staff profile card)? *

YesNo

Emergency Contact

Emergency Contact Name *

Phone Number *

Relationship *

Helping Hands Support Work Uniforms

Do you understand as a safety requirement you must wear enclosed shoes on shift? *

Yes, understoodNo, I don't understand

Visa Declaration (if applicable)

Visa Type

Temporary Skill Shortage (TSS) Visa (Subclass 482) Working Holiday Visa (Subclass 417) Student Visa (Subclass 500) Partner Visa (Subclass 820/801)

Other (Please specify)

Visa Grant Number

Visa Expiry Date

Are there any conditions on your visa that affect your ability to work?

YesNo

Have you applied for any other visa that may affect your work rights?

YesNo

If you have answered 'Yes' to previous questions, please provide further details here

Evidence of Work Rights (Passport, Visa Grant Notice or VEVO Check Results)

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Work Rights Confirmation:

I have the right to work in Australia as per the conditions of my visa.
I understand that it is my responsibility to ensure my visa remains valid and to notify my employer of any changes to my visa status or work rights.

Employee Declaration

I declare that the information provided in this Work Rights Verification form is true and correct to the best of my knowledge. I understand that providing false or misleading information may result in disciplinary action, including termination of employment. I agree to notify my employer immediately of any changes to my visa status or work rights.

Visa Declaration Signature

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Part Two: Payroll Information

Tax Information

Please download and complete your Tax File Number Declaration Form as soon as possible.

For detailed instructions on how to complete your Tax File Declaration online please visit:

https://www.ato.gov.au/forms-and-instructions/tfn-declaration/how-to-complete-the-online-form-payee?anchor=Howtocompletetheonlineformpayee#Howtocompletetheonlineformpayee

Tax File Number

TFN Declaration Upload

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Bank Account Information

Name account is held under *

BSB *

Account Number *

Authorization Agreement: I hereby authorize Helping Hands Support Work Pty Ltd (HHSW) to initiate credit entries and, if necessary, debit entries and adjustments for any credit entries made in error to my account(s) listed above. This authority is to remain in full force and effect until HHSW has received written notification from me of its termination in such time and in such manner as to afford HHSW and the financial institution(s) a reasonable opportunity to act on it. I understand that it is my responsibility to ensure that the account information provided is accurate and to notify HHSW of any changes to my account information promptly. *

Superannuation Information

Do you have an existing Superannuation fund? *

YesNo

Superannuation Fund Name?

Superannuation Fund USI?

Superannuation Member Name?

Superannuation Member Number?

Would you like to use HHSW Default Super fund? *

YesNo

Superannuation Standard Choice Form completed?

YesNo

If you have not completed the Superannuation Standard Choice form, please complete via the following link:

https://www.caresuper.com.au/sites/default/files/2023-10/employeechoiceform-1462.1-0923-iss2-webi-20231017.pdf

Superannuation Standard Choice Form Upload

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Part Three: Compliance Documents

NDISWC (Yellow Card) *

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If application in progress - please provide application number in comments section.

Working with Children Check (Blue Card) *

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If application in progress - please provide application number in comments section.

National Police Check *

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First Aid/CPR Certificate *

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If awaiting renewal please advise in comments

Mental Health First Aid Certificate

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Manual Handling Certificate

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Assist with Medication Certificate

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Certificate III in Aged/Individual Support (Disability)

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Other certifications

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Comments

Part Four: Driving History Declaration Questionnaire

1. Do you currently hold a valid driver’s license? *

YesNo

Drivers License *

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2. How long have you held a driver’s license? *

Less than 1 year1-2 years3-5 yearsMore than 5 years

3. Have you ever had your driver’s license suspended or revoked? *

YesNo

4. Have you ever been convicted of any traffic-related offenses? *

YesNo

5. Have you been involved in any motor vehicle accidents in the past 5 years? *

YesNo

6. Have you received any traffic violations in the past 3 years? *

YesNo

7. Do you currently have any pending traffic-related charges? *

YesNo

8. Do you have any medical conditions that may affect your ability to drive? *

YesNo

If you have answered 'Yes' to any of the questions above, please provide thorough details here (including date, charge and penalty if applicable):

9. Do you have comprehensive car insurance? *

YesNo

Comprehensive Vehicle Insurance Certificate *

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10. What vehicle do you drive? *

11. Do you hold a Drivers Authority Card

YesNo

Drivers Authority Card

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Part Five: Medical Declaration Questionnaire

1. Do you have any chronic medical conditions? *

YesNo

If yes, please describe

2. Do you have any allergies (food, medication, environmental)? *

YesNo

If yes, please describe

3. Have you ever had any serious injuries or surgeries? *

YesNo

If yes, please describe

4. Do you have any physical or mental health conditions that might affect your ability to perform your job? *

YesNo

If yes, please describe

5. Have you ever experienced any work-related injuries or illnesses? *

YesNo

If yes, please describe

6. Are there any specific tasks you are unable to perform due to medical reasons? *

YesNo

If yes, please describe

Declaration of Physical and Mental Fitness: I declare that I am physically and mentally fit to perform the duties required for my position. I will inform the company of any medical conditions or changes to my health that may affect my ability to perform my job safely and effectively. *

Part Six: Consents & Acknowledgements

As a new Employee, I hereby consent to the collection, use, and processing of my personal data by Helping Hands Support Work Pty Ltd (HHSW) for the purposes of:

1. Employment-related activities, including but not limited to:

- Payroll processing
- Benefits administration
- Performance evaluations
- Training and development

2. Compliance with legal and regulatory requirements, including:

- Taxation
- Workplace health and safety
- Equal employment opportunity (EEO) reporting

3. Communication regarding employment-related matters, such as:

- Job assignments
- Training opportunities
- Company policies and procedures

4. Emergency contact purposes, including:

- Contacting my designated emergency contact in the event of an emergency situation.

I understand that my personal data will be stored securely and will only be accessed by authorized personnel for legitimate business purposes. I also understand that I have the right to request access to, correction of, or deletion of my personal data in accordance with applicable privacy laws. *

As a new employee, I have provided true and accurate information within this form and have notified my employer of all relevant tax and superannuation information. I also consent to this information being stored both electronically and in printed formats. *

Sign here

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Date Signed *