Name *
Name
Address *
Address
Do you have a current drivers licence? *
Are you legally entitled to work in New Zealand? *
If your application is successful when could you commence employment? *
If your application is successful when could you commence employment?
Do you have any medical condition or injury, which may affect your ability to effectively carry out the functions and tasks of the position applied for (e.g. hearing loss, occupational overuse injuries, back injuries etc)? *
Have you ever been convicted, discharged without conviction, or experienced police diversion as a result of any criminal charges, or do you have any criminal charges pending? A criminal charge is one in which it is alleged that you have broken the law in some way, including, but not limited to, sexual crimes; any offence involving the harm or exploitation of children, violence or dishonesty. (This also applies to traffic offences in the last 24-month period.) *
Employment is subject to verification through a Third Party Criminal Record Check to be completed on commencement of work and can be terminated if this reveals undisclosed Criminal Record.
Choose which software and level of proficiency is applicable to you
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Please give details of at least two referees whose consent you obtained and who we can contact for a confidential reference. Where possible, references should be able to give work-related information that will assist with this application:
Name *
Name
Reference 2
Name *
Name
Reference 3
Name
Name
Declaration
Tick the boxes to indicate your agreement to the Declaration
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Name *
Name
Date *
Date