Employment

Personal

Name *

Date of Birth *

Phone *

Email *

Street Address *

Suburb *

Do you hold a NZ Drivers Licence? *

Yes

Employment Type *

Full Time

Part Time

Position Seeking *

Date Available *

Salary Desired *

IRD Number *

Bank Acct *

Tax Code *

Are you legally eligible for employment in NZ? *

Yes

Please Describe Your Visa Status *

During the last ten years, have you ever been convicted of a crime other than minor traffic offense? *

Yes

Please Explain Your Convictions *

Do you have any medical or health related issues that can affect your performance at work? *

Yes

Please Explain Your Health Related Issues *

Are you taking any regular medication? *

Yes

Please Explain Your Medical Requirements *

Education

Qualification

Year Obtained

Institute

Location

Other Qualification

Year Obtained

Institute

Location

Employment History

Employer One

Position Held

Start Date

Finish Date

Reason For Leaving

Duties

Employer Two

Position Held

Start Date

Finish Date

Reason For Leaving

Duties

References

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Applicants Certification and Agreement

I hereby certify that the facts set forth in the above employment application are true and complete to the best of my knowledge and authorize NZ Devanning Ltd to verify their accuracy and to obtain reference information on my work performance. I hereby release NZ Devanning Ltd from any/all liability of whatever kind and nature which, at any time, could result from obtaining and having an employment decision based on such information.

I understand that, if employed, falsified statements of any kind or omissions of facts called for on this application shall be considered sufficient basis for dismissal.

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