QT Cleaners Job Application

Application for employment:

Please read through the form before filling out the application
Applying for Position*
Full Name*

First NameLast Name
Date of Birth*

DayMonthYear
Current Address

Street Address

Street Address Line 2

CityRegion

Post CodeCountry
Phone Number*
Email Address*
Are you a New Zealand Resident?

YesNo
If no, what visa do you currently hold?
Do you have a New Zealand IRD number?

YesNo
Are you currently employed?

YesNo
If yes, who with?
If no, who was your previous employer?
What cleaning experience do you have?

NoneHospitalsDomesticCommercialIndustrialSchoolsOther
Do you have a driver's licence?

Yes, New Zealand licenceYes, International licenceNoOther
How did you hear about this position?

Friend / relativeInternetNoticeboardNewspaperAccommodationOther
Please check any days you CANNOT work

MondayTuesdayWednesdayThursdayFridaySaturdaySunday
Are you prepared to work on public holidays if required?

YesNo
Are you prepared to handle all products, materials or equipment used in the industry?

YesNo
If no, please state a reason
What transport arrangements do you have to attend your place of employment?

My own carCarpoolMotorcycleCyclePublic TransportWalkOther
Are you a smoker?

YesNo
If yes, are you prepared to adhere to all site smoke policies?

YesOther
Do you have any medical conditions that may affect your ability to carry out the tasks of this job?

YesNo
If yes, please provide details
Are you on any prescribed medication?

YesNo
If yes, please provide details
Have you been convicted of a criminal offence in the last 5 years?

YesNo
Are you awaiting the hearing of a charge in civil or criminal court?

YesNo
Please list your previous employment (Employer, location, position, reason for leaving, etc.)
Please provide at least two references from your previous employment (Name, phone, email, position, postal / business address)
Do you have a spouse, partner, relative or household-member working here, or elsewhere in the industry?

YesNo
If yes, who? And where do they work?
If your application is accepted, when could you commence employment?

DayMonthYear
Upload Resume

Upload a File

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All Applicants will need to submit a non-positive drug test at your own expense before you are made a Job Offer. We are registered approved urine sample collectors and testers and can do this on site for $30.00 or you can have it done at any of the local medical centres. Do you agree to this?*

YesNo
Do you consent to the Company retaining the information contained in this application form for the purposes of considering your suitability for any other position which may arise with this company in the future?*

YesNo
I declare that to the best of my knowledge the information in this application form and the information contained in any resume provided is correct and I understand that if any false or deliberately misleading information is given, or any material fact suppressed, I will not be accepted, or if I am employed, my employment will be terminated.*

I agree
Please verify that you are sentient*
Should be Empty:

Application for employment: