Application Form

Application Form - Youth Mentor

MacStrong Mentors is committed to being an equal opportunity employer and to ensure that all workers and other people we deal with are treated fairly and are not subjected to unfair or unlawful discrimination. We welcome applications from all sectors of the community.
Personal Details
Full Name*

First NameLast Name
Alternative / Previous / Preferred Names

Preferred NamePrevious Names
Ethnicity*
Iwi - if applicable
Current Address*

Street Address

Street Address Line 2

CitySuburb

Postal Code
Phone Number*

Area CodePhone Number
Email*
example@example.com
Linkedin Profile
Optional
Why do you want to join MacStrong Mentors?*
Do you know any Mentors with MacStrong*
If yes, what is/are their name(s)?
Qualifications
CV - Please add your CV in PDF Format*

Cancelof
Are you currently undertaking study/training?*

YesNo
Type of study/training and full time or part time
Employment History - Please provide your work history for the last 5 years
Proof of Identity and Right to Work
Are you a New Zealand Citizen?*

YesNo
If not, do you have resident status?*

YesNoNot Applicable
Do you have a current work permit?*

YesNoNot Applicable
Police Vetting

MacStrong Mentors has adopted a policy whereby only persons who have undertaken a New Zealand police vet with acceptable results can be selected to work with or for the company.
Do you consent to Police Vetting check?*

YesNo
Have you ever had a criminal conviction in New Zealand? (Convictions that fall under the clean slate scheme do not have to be disclosed)*

YesNo
If 'Yes' please detail.
Have you ever had a criminal conviction in another country?*

YesNo
If 'Yes' please detail.
Fitness To Undertake Work

The following information is required to assist MacStrong Mentors to meet its obligations under the Health and Safety at Work Act 2015 and to assess your ability to perform the duties of the position safely and to ensure you are not in a position where you could be placed in a situation of harm.
Do you have any medical condition(s) (including impairment) or injury that may affect your ability to effectively carry out the functions and tasks of the position applied for?*

YesNo
If 'Yes' please detail.
Transport
Do you have a current full drivers licence?*

YesNo
Do you have you own reliable vehicle?

YesNo
Do you have any current or pending endorsements?*

YesNo
Please detail
Do you have any current or pending demerit points or driver restrictions? (Including convicted traffic offences)?*

YesNo
Please detail
Working with Children
Has there ever been any cause for concern regarding your conduct with children and young people?*

YesNo
Please detail
To the best of your knowledge have you ever had an allegation made against you which has been reported to,and investigated by Oranga Tamariki?*

YesNo
Please detail
Declaration

I declare that, to the best of my knowledge, the information given is true and correct. I understand that inaccurate, misleading or untrue statements or knowingly withheld information may result in termination of service with MacStrong Mentors. I understand that this application does not constitute an offer of service. I understand that police and other checks will be required as detailed in this application.
By signing, typing your name or pasting an image of your signature you acknowledge that you have read and understood the content of this document and you are intentional signing this form.
Signature*
Date*

DayMonthYear
Date
How Did You Hear About Us?
Should be Empty:

Application Form - Youth Mentor

Personal Details

Proof of Identity and Right to Work

Police Vetting

Fitness To Undertake Work

Transport

Working with Children

Declaration