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First name

Last name

Email

Phone

Mobile

Where do you reside?Northland - (Te Tai Tokerau)
Auckland - (Tāmaki-makau-rau)
Waikato
Bay of Plenty - (Te Moana-a-Toi)
Gisborne - (Te Tairāwhiti)
Hawke's Bay - (Te Matau-a-Māui)
Taranaki
Manawatū-Whanganui
Wellington - (Te Whanga-nui-a-Tara)
Tasman - (Te Tai-o-Aorere)
Nelson - (Whakatū)
Marlborough (Te Tauihu-o-te-waka)
West Coast - (Te Tai Poutini)
Canterbury - (Waitaha)
Otago - (Ōtākou)
Southland - (Murihiku)
None of the above

What relevant skills do you have?

What sort of work are you seeking?Permanent Part-time
Permanent Full-time

Would you consider temporary work while we find the right position for you?Yes
No

What relevant qualification do you have?

What is your current work status?

Hours many hours are you seeking per week?40 hours per week
30-39 hours per week
20-29 hours per week
20 or less hours per week

If successful, when are you available to start?Immediately
1 week
2 weeks
1 month
2 months
none of the above

Are you legally entitled to work in NZ?Yes
No

Please indicate your eligibility for employment in New Zealand.NZ Citizen
NZ Resident
Australian Citizen
Australian Resident
NZ Work Permit or Visa
Student Visa
None of the above

Part of our company's application process is to complete a criminal history check. Do we have your consent to undergo this process?

Do you have any present civil / criminal convictions; not including any that are concealed under the Criminal Records (Clean Slate Act); or any civil / criminal charges pending?Yes
No

Do you currently or have you ever had any illness, medical condition or injury that might effect your ability to safely and consistently carry out the duties of the position being applied for? For example repetitive strain injuries such as OOS (Occupational Overuse Syndrome), hearing loss etc.Yes
No

If yes, please provide details and state how we might accommodate your needs?

If Policy requires you to undertake drug testing. Are you willing to undertake drug testing?Yes
No

The information supplied by me in this application form and in any resume or other document submitted is given voluntarily and is to the best of my knowledge true, accurate and complete in all respects.Yes
No

I agree to my information being retained and considered for future suitable job opportunities.Yes
No

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