QT Cleaners Job Application

Application for employment:

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

First Name Last Name
Date of Birth *

Day Month Year
Current Address

Street Address

Street Address Line 2

City Region

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

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

Yes No
Are you currently employed?

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

None Hospitals Domestic Commercial Industrial Schools
Do you have a driver's licence?

Yes, New Zealand licence Yes, International licence No
How did you hear about this position?

Friend / relative Internet Noticeboard Newspaper Accommodation
Please check any days you CANNOT work

Monday Tuesday Wednesday Thursday Friday Saturday Sunday
Are you prepared to work on public holidays if required?

Yes No
Are you prepared to handle all products, materials or equipment used in the industry?

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

My own car Carpool Motorcycle Cycle Public Transport Walk
Are you a smoker?

Yes No
If yes, are you prepared to adhere to all site smoke policies?

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

Yes No
If yes, please provide details
Are you on any prescribed medication?

Yes No
If yes, please provide details
Have you been convicted of a criminal offence in the last 5 years?

Yes No
Are you awaiting the hearing of a charge in civil or criminal court?

Yes No
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?

Yes No
If yes, who? And where do they work?
If your application is accepted, when could you commence employment?

Day Month Year
Upload Resume
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? *

Yes No
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? *

Yes No
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 *
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Application for employment: