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Personal Information

First Name *

Last Name *

Mobile Number *Example: 0412XXXXXX. Max 10 digits. No spaces. Do not include '+' or country code

Email Address *

Address *

Street address *

City *

State *

Postcode *

Upload Curriculum Vitae *

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pdf, doc or docx. Max 2MB.

Where and what are you applying for

State Applying For

VICNSWWA

Position seeking (Vic)

Patient Transport OfficerAmbulance AttendantCritical Care Nurse

Position Seeking (NSW)

Trainee Patient Transport OfficerPatient Transport OfficerAmbulance Attendant (Registered Nurse / Paramedic)

Position Seeking (WA)

Community Transport OfficerPatient Transport OfficerAmbulance Attendant (Paramedic)

Employment Type Seeking *

FulltimePart-timeCasual

Select all that apply

Number of shifts seeking per week *

1 shift2 shifts3 shifts> 3 shifts

If successful, how soon can you start? *

About You

Tell us a little about yourself and why you wish to apply for a position at NPT *

Highest Qualification *

Certificate III in Non Emergency Patient TransportCertificate IV in Health CareDiploma of Emergency Health / Diploma of Paramedical ScienceDiploma of NursingBachelor of NursingBachelor of ParamedicinePost grad certificate in Critical CareSeeking equivalency of recognition of current studies (e.g. Bachelor of Nursing or Bachelor of Paramedicine)

Upload certified copy of Qualification *

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pdf, jpg, jpeg or png. Max 2MB.

Upload certified copy of post grad qualification *

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pdf, jpg, jpeg or png. Max 2MB

Upload current ALS certification *

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pdf, jpeg, jpg or png. Max 2MB

AHPRA Registration Number

Upload completed Course Mapping Document

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If seeking for equivalency of units completed in your current undergraduate documents, please download a copy of the "Fact Sheet - Seeking Equivalency of Qualification", complete the Course Mapping component and upload here together with supporting documentation e.g. First Aid qualification, Driving Units etc. Accepted file types: pdf, jpeg, jpg or png. Max 2MB

Upload evidence of 400 hours of supervised onroad clinical practice *

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Under the Victorian NEPT regulations, applications for an ATA position, evidence of 400 hours of supervised onroad clinical practice from either a ATA, CI or Paramedic. jpeg, jpg, png or pdf. Max 2MB

Drivers Licence & record

Drivers Licence Number

Drivers Licence Expiry Date

Drivers Licence Type

Car LicenceLight RigidMedium RigidHeavy Rigid

Please note that Probationary Licences can not be accepted

Upload certified colour copy of Drivers Licence (both sides) *

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jpeg, jpg, pdf or png. Max 2MB

Upload Driver History Record issued by the relevant State Roads Authority *

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pdf, jpeg, jpg or png. Max 2MB

Residency Status

Residency Type *

Upload Proof of Residency *

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Please provide one of the following: Australian/New Zealand Citizens : copy of birth certificate, passport, citizenship certificate Temporary/Permanent/Work/Student Visa : copy of Visa. Accepted file types: pdf, jpg, jpeg or png. Max 2MB

National Police Check

The Police Check must indicate the position type e.g. Patient Transport Officer, Ambulance Attendant, Registered Nurse or as a minimum state Patient Transport

If you require a police check. NPT recommends intercheck: https://www.intercheck.com.au/ This is provided a reduced rate.

Issued Date *Must have been issued within the last 3 months

Upload copy of National Police Check *

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pdf, jpg, jpeg or png. Max 2MB

Working with Children Check

WWCC Card Number *

WWCC Expiry Date *

WWCC Type

EmploymentVolunteer

Please note that if you have a Volunteer WWCC, this must be converted to an Employment card prior to being offered an employment contract

Upload colour copy of WWCC card *

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pdf, jpg, jpeg or png. Max 2MB

Tell us about your immunisation status

As a patient transport professional, you may be exposed to infectious agents either through direct contract with an infectious patient or indirectly through a contaminated surface or environment. Therefore NPT is committed to ensuring that any employee has the required immunisations to protect themselves from vaccine preventable conditions. There is a number of mandatory and recommened vaccinations that NPT requires evidence of protection. Please speak with your GP if you require further information about these vaccination requirements. NPT will be unable to process any application for employment until evidence of the required vaccines has been provdied.

Mandatory Vaccinations

It is a requirement of your employment within the health industry that have been immunised against preventable diseases. NPT requires evidence of your immunisation status prior to employment. This is to ensure compliance with current Australian Infection Control and Occupational Health Requirements is met in order to protect you and the patients transported from exposure to vaccine preventable diseases.

Vaccination	Status Requirement	Evidence Requirement
Hepatitis B	At least 3 vaccinations followed by immunity confirmed by serology	Evidence of at least 3 vaccinations AND Copy of results of immune status (blood test – Hepatitis B Surface Antibody
Varicella (chickenpox)	Completed course OR Confirmed immunity	Evidence of two (2) doses of Varicella vaccine; OR Results of blood test demonstrating immunity to Varicella
Pertussis	Booster within 10 years	Evidence of most recent booster of Pertussis containing vaccine during adulthood (maximum 10 years)
Measles, mumps, rubella (MMR)	Born before cut-off; OR Completed course; or confirmed immunity	Were you born in Australia before 1966? YES/NO If NO: evidence of two (2) doses of Measles / Mumps / Rubella vaccination; OR Results of blood test demonstrating immunity to Measles, Mumps and Rubella (all three)
Influenza	Current vaccine	Confirmation of most recent year’s vaccine - if seeking an exemption, you must provide a letter from your GP indicating why you are contraindicated
COVID-19	Completed course	Proof of completion of COVID-19 vaccine course plus at least 1 booster e.g. 2 inital doses plus 1 booster. If seeking an exemption your Medicare Immunisation statement must include details of the exemption should be provided.

MMR requirements - Were you born before 1966? *

YES - no record of immunisation requiredNO

Medicare Immunisation Record *

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pdf, jpg, jpeg or png. Max 2MB

Upload Serology confirming Hepatitis B immunity *

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pdf, jpg, jpeg or png. Max 2MB

Upload serology of Varicella immunity *

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pdf, jpg, jpeg or png. Max 2MB

Tell us about your health

The information you are required to provide will remain confidential to the Recruitment Team.

Please complete all sections. The pre-employment health questionnaire does not determine your suitability for employment. This assessment is only one component of the overall recruitment process. It is not the only factor determinig whether you are successful in gaining employment.

Please note that you may also be required to undertake a pre-employment functional assessment. If this is required, you will be advised by e-mai.

General Health Screening

1. Have you been involved in any motor vehicle accidents resulting in personal injury? *

YesNo

Please note the date of injury and the nature of the injury/illness?

2. Have you ever lodged a claim for workers compensation? *

YesNo

Please note the date(s) of the workers compensation claim and the nature of the injury/illness

3. Have you suffered back pain or strain injury (including back surgery)? *

YesNo

Please provide more details of your back pain or strain injury

4. Have you suffered from shoulder, neck or arm pain or strain? *

YesNo

Please provide more details of your shoulder/neck/arm pain or strain

5. Have you suffered from hip, knee or ankle pain? *

YesNo

Please provide more details of your hip, knee or ankle pain

6. Have you had a full medical clearance for any injury identified in questions 1 to 5? *

YesNo

Please give details

7. Are you receiving any ongoing treatment for injuries identified in questions 1 to 5? *

YesNo

Please provide details of the treatment you are receiving

Do you suffer from any medical condition (including physical, psychiatric, psychological) for which you are receiving treatment? *

YesNo

Please provide details of any medical treatment

If you answered YES to any of the above conditions, please give details (e.g. year, diagnosis, treatment, medication etc):

Health Declaration

Please indicate your declaration by completing the questions below. Please note that by responding to these questions and uploading this document as part of your application, you are providing electronic declaration of the following statements: *

YesNo

I hereby declare that the above statements and answers are true and correct to the best of my knowledge. I have read the inherent requirements for the position I am applying for and I understand and can fulfil these requirements.

YesNo

I agree to the release of medical information to my prospective employer that directly relates to my ability to carry out the tasks adequately and safely in this position.

YesNo

I am aware that any false or misleading statements may impact on my appointment or continued employment with NPT

YesNo

Signature of the Applicant *

Clear

Pre-screening assessment

Comments regarding Credentials

Immunisations Comments

Health Assessment Comments

Pre-screen assessment outcome

Assessment Outcome *

Pending ReviewProceed to InterviewNot Suitable

General Comments

Pre-screening completed by *

Date Completed

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Vaccination	Status Requirement	Evidence Requirement
Tetanus	Last Booster	Proof of most recent booster
Meningococcal	Completed course	Proof of completion of Meningococcal vaccine course
Hepatitis A	Completed course	Proof of completion of Hepatitis A vaccine course

Personal Information

Where and what are you applying for

About You

Drivers Licence & record

Residency Status

National Police Check

Working with Children Check

Tell us about your immunisation status

Mandatory Vaccinations

Recommended

Tell us about your health

General Health Screening

Health Declaration

Pre-screening assessment

Pre-screen assessment outcome

Save and Complete Later