Last updated November 2019 Please check the ACECQA website to ensure that you are using the current version
© 2019 Australian Children’s Education and Care Quality Authority
Skills Assessment
Employment Experience Template
Employment Experience Template
This form must be completed by you. Use a separate form for each period of employment you wish to claim.
1. Business details
Business name
Business address
State or province Postcode Country
Phone number
Business email
Business website
Position title
Are you currently employed here? Yes No
Date commenced Date completed
(Day/Month/Year) (Day/Month/Year)
Employment Full time Part time Casual / Voluntary
Normal working hours Salary
per week (Per annum)
2. Responsibilities of the role
Briefly describe the standard responsibilities of your role:
/ /
/ /
( )
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Skills Assessment
Employment Experience Template
Describe the tasks and duties you were required to perform in your employment capacity, and provide key
examples of when you demonstrated the required competencies of the role:
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Skills Assessment
Employment Experience Template
3. Applicant Declaration
Please tick each clause below and sign the declaration
I, (the applicant) declare that:
I was employed for the period specified and in the role identified.
I conducted the specified tasks and duties in the capacity of my employment.
I have not misappropriated (copied and pasted) the description of my occupation responsibilities from
any third party website, such as: ANZSCO.
I understand that providing false or misleading information is an offence and all the information I
have provided is true and correct.
Day Month Year
Applicant Date
signature
/ /
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