Group Coordinator

First name

Last name

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Are you either a New Zealand or Australian citizen or a permanent resident of New Zealand?

If no, do you have a current New Zealand work permit?

If yes to above, please advise expiry date and any conditions associated with your visa.

Please select the skills that reflect your experience

How did you hear about this opportunity?

Do you have any condition, illness, injury, or disability that could reasonably be expected to affect your ability to carry out the work of the position you are applying for?

If yes, please provide details, including what support you might need.

I confirm that I, or my immediate family, have no interests which may conflict with the interests of the IoD.

I understand that if I, or my immediate family, have any interests that may conflict with the interests of the Institute of Directors (IoD) they must be disclosed to the IoD at this time.

Do you have any criminal convictions [not including any concealed under the Criminal Records (Clean Slate) Act 2004 e.g. convictions over 7 years old not resulting in a custodial sentence etc? Please note: Any offer of appointment will be conditional on completion of a Ministry of Justice/Criminal history check with satisfactory results.

Have you been convicted of any offence against the law in New Zealand or elsewhere other than minor traffic offences?

If yes, please provide details

Do you have any criminal charges pending in New Zealand or elsewhere other than minor traffic offences?

Have you been discharged without conviction or used diversion?

If yes, please provide details.

I certify that the information I have provided is correct and that any incorrect, misleading or omitted information may impact future appointment with the IoD.

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