Employment Application

Position you are applying for

Personal/Contact Details

Australian Citizenship/Residency Status

Probity Checks

Previous Applications

Please specify the details of your previous application.


Are the people you have named aware that you have nominated them as referee?


Please provide specific details for example the date of the incident & where the incident occurred. You should include:

  • Incidents that occurred overseas
  • Incidents when you are found not guilty
  • Any failures to appear in court
  • Matters which have not yet been finalised

Please note that if you do not disclose accurate details, this could affect your employment outcome.


Medical and/or Health Conditions

Challenge Foundation has an obligation to ensure all its employees have a safe working environment. To avoid inadvertently placing you in a situation where your safety is at risk, we need to ensure we have done everything reasonably practicable to satisfy ourselves that you are physical & mentally capable of performing the tasks associated with the positon for which you are being considered. To satisfy our responsibility under the Work Health and Safety legislation please answer the following questions.

Do you have or have you ever had any of the following health conditions?

  • Copies of any nationally recognised qualifications held (e.g. Cert. 111 Disability)
  • A copy of your nationally recognised First Aid Certificate
  • A copy of your Working Visa ( if applicable)
  • A copy of your current Vehicle Registration
  • A copy of your current Vehicle Insurance (comprehensive or third party property- not Greenslip)


I certify that the information on this declaration is true & accurate to the best of my knowledge & I have not withheld any information regarding my past or health.

If I have disclosed any health conditions above, I consent to my treating doctor or other treating practitioner providing information to the pre-employment assessment team for the purpose of assessing my suitability to undertake the duties for which I have applied. Also I agree to attend a medical examination with an agreed practitioner to review the impact of the above health information I have declared on my ability to perform my duties without affecting my health & safety.

I understand that by submitting this form, I authorise Challenge Foundation to release information to the pre-employment assessment team.

I also understand that if it is found that I have provided false or misleading information I will not be employed or my contract of employment may be terminated without notice.


Recruitment Process

Shortlisted applicants will be contacted to attend an interview within two weeks of the closing date for applications. Please ensure your application reaches Challenge Foundation Goulburn Inc. by the closing date.


Privacy Declaration

Your personal information will be kept secure & confidential & will be destroyed if you are not a successful applicant.

Go to top