Acsqhc Recruitment Personal Particulars Form
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1
2Personal Particulars Form
You MUST complete this form and attach it to the front of your application. Any information
that is used for statistical purposes will be treated confidentially.
Vacancy Details
Position/Reference
20024030
/ 17-0002
Number
Classification
APS 6 Communications Officer
ACSQHC/
Australian Commission on Safety and Quality in Health Care,
Section
Communications
Personal Details
Surname
First Name(s)
Postal Address
Postcode
Telephone
(Work)
(Home)
Date of Birth
Are you an Australian Citizen?
Yes
No
Note: There is a general expectation that a person who is to be engaged as an APS employee will be
an Australian citizen (section 22(8) of the PS Act). The Australian Government considers that it is
appropriate for government employees to be Australian citizens as a demonstration of their
.
commitment to, and long-term stake in, the future of Australia
If no, do you have permanent residency status?
Yes
No
Please indicate when you are eligible to be granted Australian Citizenship
/
/
Are you a member of any of the following groups?
an Aboriginal or Torres Strait Islander
Yes
No
from a culturally diverse background
Yes
No
a person with a disability?
Yes
No
If you require any equipment or assistance at interview, please detail here:
.....................................................................................................................................................
.....................................................................................................................................................
If you would require an interpreter for interview, please advise which language: ………………
....................................................................................................................................................
ACSQHC Recruitment Personal Particulars Form
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