Miro Meihana Koata Recruitment Form
Want to work for Miro Meihana Koata? Register your interest now!
To complete this application we require a either a copy of your passport, birth certificate or drivers licence (AU/NZ residents) OR a copy of your visa and passport (non AU/NZ residents).
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Name
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First Name
Last Name
E-mail
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Phone Number
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Example: 027 1234567
Date of Birth
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/
Day
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Month
Year
2 digit day, 2 digit month, 4 digit year
Date
Gender
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Male
Female
N/A
Residency/Work Status
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Citizen
Permanent Resident
Work Permit
Address
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IRD Number
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Please provide proof of your IRD number
Bank Account Number
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Please provide proof of your Bank Account number
Are you enrolled in Kiwisaver?
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Yes
No
What % would you like to contribute to Kiwisaver
3%
4%
6%
8%
10%
Other
Work Availability (Subject to weather, day shift may be longer or shorter.)
Day Shift - 6am - 4 pm
I can only work other hours
Please let us know what hours you can work?
Do you have supervisor/team leader experience?
Yes I have worked for Miro as a supervisor before.
I would like to be considered for a supervisor role at Miro.
Emergency Contact
Ethnicity
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NZ Maori
New Zealander
Other
If NZ Maori let us know your Iwi
For example: Te Arawa
and Hapu
Do you have a New Zealand drivers licence?
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Licence Class(es)?
Example: 1, 6R, etc
Where did you hear about Miro?
Do you know anyone currently working for Miro?
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Work History
Have you worked for Miro previously?
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Do you have previous experience in Horticulture?
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Are you currently working?
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If yes what is your notice period?
What other skills, education or work experience do you have? Please include any special licenses you hold here i.e forklift etc
Attach CV and/or Cover letter (optional)
Browse Files
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Medical / Health and Safety
Have you or do you suffer from any of the following?
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Asthma
Diabetes
High Blood Pressure
Arthritis
Hearing or Sight Impairment
Dermatitis
Heart Conditions
HIV, TB, Hepatitis
Allergies
Blackouts, Fits, Seizures
Epilipsy
Hernia
None
Are you allergic to bee stings?
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If Yes
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Do you wear glasses?
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Have you claimed for ACC in the previous 12 months?
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Have you have an injury or medical condition caused by gradual process, disease or infection, that may be aggravated or further contributed to by the tasks of this job?
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Have you suffered any serious injury or illness that may affect your ability to effectively carry out the functions and responsibilities of the position(s) you wish to apply for?
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Do you have medication that needs to be with you at all times while at work?
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Please provide medication details
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Will you be travelling in your own transport to work?
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Declaration and Consent
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Do you have any criminal convictions?
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Please provide details
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Are there any charges pending against you?
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Please provide details
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Are you currently required to attend Periodic Detention or on Probation?
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Please provide details
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I consent to Miro seeking information, on a confidential basis, about me from any previous employers/referees and authorise the information sought to be released for the purposes of ascertaining my suitability for the position for which I am applying. The information received by Miro is supplied in confidence and evaluative material will not be disclosed. I also consent to Miro seeking information from Government Agencies for employment related purposes.
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I understand that Miro recognises its responsibilities and obligations imposed under the Health and Safety in Employment Act 2015 and to this purpose I may be asked to undergo a pre-employment drug/alcohol test. I also acknowledge that I may be drug/alcohol tested, following a workplace accident/incident, reasonable cause, randomly or internal transfers.
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I understand that Miro may take my photo for security and identification purposes, and also complete a security check with NZ Police.
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I give consent for Miro to retain my email address to be used for electronic direct mail (EDM) processes. The purpose of retaining this information is to ensure Miro gathers analytics to assist with future workforce planning and to contact you for marketing purposes.
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I consent to Miro using any photo or images taken of me during work and/or participating in work social activities on the Internet (world wide web), in print publications, video and multimedia presentations, and/or for any purpose which may include, but not limited to display, training material, public relations, marketing or designs. I understand that my name and/or the images may be used for display or advertisement for the website and/or literature published. I hereby waive the right to inspect or approve the images prior to any form of usage. I understand that the images may be modified to be used as design elements.
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I declare that all information supplied in this application and any resume provided is true and 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 also understand that any false information given in relation to my medical history with regards to gradual process, disease or infection can result in my loss of entitlement for any compensation from ACC.
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