FORM – APPLICATION FOR EMPLOYMENT

CONFIDENTIAL

You will be required to sign a declaration at the end of this form. Please read the questions and the declaration before beginning to fill in this form.

Please complete all sections of this form. Attach a covering letter and a brief CV detailing education and training, full employment history, specific skills and abilities and any other details that you feel will be useful to support your application. (Please do not send original references or other documents)

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|Position applied for: |
|First (given) names: |Surname (family name): |
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|If you are known by any other names, please record here: | |
|Residential Address: |
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|Postal Address (if different): |
|Contact phone numbers: |Day: Evening: Mobile phone: |

Right to Work

|Are you a New Zealand citizen, or a permanent resident of New Zealand, or do you have a | YES NO |
|current work permit? | |
|If you have a current work permit please advise the expiry date: | (expiry date) |
|(Please note that you will be required to provide evidence of your right to work in New Zealand if you are offered employment.) |

Driver’s Licence

|Do you have a current drivers’ licence? | YES NO |
|Date Issued: Licence Type: Expiry Date: | |
|Are you awaiting the hearing of any charges for driving offences? | YES NO |
|Please note that you will be required to provide your driver’s licence if you are offered employment in a position where driving is |
|required. |
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|Education | |
|Starting from the most recent, please list here schools/universities/polytechnics you have | |
|attended and the dates and any qualification(s) obtained. | |
|School/university/polytechnic attended: Name: From To | |
|Qualifications gained: