GUIDELINES
DCJ recognises that secondary employment can contribute to an employee acquiring additional skills and knowledge. Further, DCJ applauds the generosity of spirit and the willing sacrifice DCJ employees make to volunteer for, and enrich our, communities outside their official duties as public servants.
Employees may engage in SEUW if they meet the relevant requirements under the Government Sector Employment Regulation 2014 and the relevant requirements under the
Secondary Employment & Unpaid Work Policy and Procedure
.
The policy and procedure is designed to continue the generosity and commitment DCJ employees have to the community in a manner that allows DCJ to ensure that the performance of employee's primary public duties is not adversely affected and to manage any COI that may arise. It is essential that an employee's SEUW does not interfere with or impede the functions and responsibilities of DCJ.
I have read the above guidelines
EMAIL REQUIRED
To save draft, you must provide a valid email address.
INCOMPLETE FIELDS!
You have not completed all mandatory fields on the form.
Please check any fields marked with a
.
INVALID SEUW ID!
The SEUW ID number you have provided is not valid.
The SEUW ID number must match a SEUW application submitted by you (using the same email address) which has been approved by a delegated officer.
Check that you have entered the same email address in the "Declarant's Details" section above that you used when you submitted the previous application.
EMAIL REQUIRED
You must provide a valid email address.
INVALID COI ID!
The COI ID number you have provided is not valid.
The COI ID number must match a COI declaration submitted by you which has been approved by a delegated officer.
Check that you have entered the same email address in the "Declarant's Details" section above that you used when you submitted the COI declaration.
SECONDARY EMPLOYMENT AND UNPAID WORK (SEUW) FORM
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Declarant's Details
Employee ID/Serial #:
Full Name:
Email Address:
Substantive Role Title:
Are you a Senior Executive (including TAA)?:
Yes
No
Contact Number:
Entity:
[Select one]
Advocate for Children and Young People (ACYP)
NSW Trustee and Guardian (TAG)
Department of Communities & Justice (DCJ)
Multicultural NSW (MNSW)
Ageing and Disability Commission (ADC)
Division:
Select entity above...
District/Directorate:
Branch (optional):
Employment Status:
[Select one]
Public Service Employee (ongoing, temporary/termed)
Non Public Service Employee (i.e. Contractors, Contingent Workforce etc.)
Employment Category:
[Select one]
Full time employee (35hrs+)
Part time employee
Casual employee
Volunteer
Graduate
Other
I declare the following
I have read and understand my responsibilities under the
Code of Ethics and Conduct for NSW government sector employees
, including the obligation to declare all my private interests (financial, business, personal or other interests or relationships) known to me at the time of completing this form.
I attest compliance with the requirements outlined in the
Secondary Employment and Unpaid Work (SEUW) Policy & Procedure
.
I acknowledge that the information provided in this form is to assist in the appropriate visibility, oversight and management of my secondary employment/unpaid work.
I understand that personal and health information collected, managed and disclosed on this form will comply with the requirements of the NSW Privacy Laws as outlined in the Department’s Privacy Management Plan.
I give permission for DCJ to contact my SEUW employer identified below in relation to this application.
I believe the SEUW for which I am seeking approval will not:
interfere with my role within DCJ
be undertaken during my normal working hours
be varied without further application
exceed hours of work or work demands that may compromise work health and safety
I acknowledge that my SEUW:
will expire on 30 November each year, irrespective of when the last approval was granted
is conditional on the above undertakings continuing and I must reapply if these circumstances change
Supervisor
's Details
Supervisor
's Name:
Supervisor
's Role Title:
Supervisor
's Email Address:
You cannot select yourself
Supervisor
's Contact Number:
Application Type
Application type:
New application/registration
Application/registration to continue an existing arrangement
Amend/update an existing arrangement/registration
Type of work:
Secondary Employment
Unpaid Work eg. Volunteer work
Application Details
Name of Employer:
Nature of business:
Status of work:
[Select one]
Ongoing
Temporary
Casual
Employment type:
[Select one]
Full-time
Part-time
Casual
Unpaid work
Location:
Proposed hours of work:
Frequency:
[Select one]
Daily
Weekly
Fortnightly
Monthly
Yearly
Commencement Date:
Incorrect date format
Type of work to be undertaken:
Work pattern:
Morning shift
Day shift
Evening shift
Overnight shift
Weekend shift
On-call shift
Other
Hours break:
On average, how many hours break will there be between your role
and commencing this work?
Conflict of interest:
Yes
No
Does this work create any actual, potential or perceived conflicts
of interest with your work within the Stronger Communities cluster?
Checklist to identify any adverse effects the SEUW may have on the public duties of the employee
To assist with a risk assessment the SEUW may have on the public duties of the employee, the following should be considered:
Is there a potential for employee fatigue?:
Yes
No
Is there a potential for consecutive shifts or double shifts worked?:
Yes
No
N/A
Is there a potential for excess travel to and from the private/secondary employment including long periods of driving?:
Yes
No
N/A
Is there a potential for the employee to work excessive hours?:
Yes
No
Is there a potential for the employee to NOT have at least an 8 hour CONTINUOUS break within a 24 hour period?:
Yes
No
Is there a potential for this work to affect any pre-existing medical condition or current return to work rehabilitation plan?:
Yes
No
N/A
Is there a return to work plan in place?:
Yes
No
N/A
Will this work create any health or safety concerns?:
Yes
No