Role applying for * Disability Support Worker (casual) Senior Support Worker (casual, across three SIL homes) Either
Type of work you want * SIL home shifts Individual (1:1 in-home and community) supports Either — happy to do a mix
Full name * First Name Middle Name Last Name
Please enter a valid phone number.
Format: ************.
Email address * ******
Your suburb (for travel to Coopers Plains / Wellington Point and surrounds)
Work Rights and Checks
Right to work in Australia * Australian citizen Permanent resident Visa holder with work rights
NDIS Worker Screening Clearance * Current Applied — pending Not yet
Working with Children Check (Blue Card) * Current No
Licences, Certifications, and Qualifications
First Aid (HLTAID011) expiry date * 2 digit day, 2 digit month, 4 digit year Date
CPR (HLTAID009) expiry date * 2 digit day, 2 digit month, 4 digit year Date
Do you hold an open Queensland driver licence?
* Yes No
Do you have a reliable, comprehensively insured vehicle and are you willing to transport the people you support?
* Yes No
Have you completed the NDIS Worker Orientation Module (Quality, Safety and You)?
* Yes No
Qualifications Certificate III in Individual Support Certificate IV in Disability Diploma of Community Services None yet Other
Experience and Availability
Disability support experience *
Tell us where you've worked and in what settings (SIL, community, aged care, mental health etc.)



* Please answer in your own words — we'll ask you to talk through your examples at interview.
Experience implementing behaviour support plans / restrictive practice reporting * Yes No
Availability * Rows Morning Afternoon‐Evening Sleepover Active night Monday Tuesday Wednesday Thursday Friday Saturday Sunday
Which of these can you commit to regularly?
* Weekday mornings Weekday afternoons/evenings Weekends Sleepovers or active nights
Minimum number of shifts per week you can commit to *
Do you currently work for another disability provider or employer?
* No Yes
Can you take wide-ranging shifts week to week (a mix of mornings, afternoons, weekends and sleepovers or active nights) to meet the needs of the people we support?
* Yes No
2 digit day, 2 digit month, 4 digit year Date
Application Questions, Resume, and References
Tell us about a time you supported someone to make a choice you didn't agree with.
What did you do?
* Please answer in your own words — we'll ask you to talk through your examples at interview.
Referee 1 name *
Referee 1 role *
Referee 1 relationship to you *
Referee 1 phone * Please enter a valid phone number.
Format: ************.
Referee 2 name *
Referee 2 role *
Referee 2 relationship to you *
Referee 2 phone * Please enter a valid phone number.
Format: ************.
I confirm the information in this application is true and complete, and I consent to Able Mentor Services contacting my referees and verifying my clearances.
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📌 Senior Support Worker (Brisbane)
🏢 Example
📍 Brisbane