Pukatono Tūranga | Application for Employment

Pukatono Tūranga | Application for Employment

To be completed personally by the applicant
Kia tupato | Note: Mena e whakakī i tēnei puka kahore e tohu ana he herenga anō mo Sport Northland kia uru atu ki te kaitono | The completion of this form does not indicate that there is any obligation of Sport Northland to engage the applicant.

Kaupapa | Purpose: I koha ēnei kōrero mō te aromatawai i tō ake tika ki Sport Northland, ka uru pea ki ngā whakarerekētanga mahi ki Sport Northland | This information is collected for the purpose of assessing your suitability for employment at Sport Northland which may include subsequent changes in employment with Sport Northland.
Tono mo te tūranga | Position applied for:*
Mōu | About You
Ingoa | Given names (on birth certificate):*
What is your preferred name?
Whānau Ingoa | Family name:*
What is your preferred pronoun?
Iwi
Hapū
Marae
Ō Pārongo Whakapā | Contact Details
Wāhi noho | Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Īmera | Email*
example@example.com
Nama waea | Phone Number (Home)

Area CodePhone Number
Waea pūkoro |Phone Number (Mobile)*

Area CodePhone Number
Te Mana Mahi Ture | Legal Work Status
E āhei ana koe ki te mahi ki Aotearoa? | Are you legally entitled to work in Aotearoa New Zealand?*
Mātauranga | Education
Tohu | Qualifications (E.g., NZQA, School Certificate, University Entrance, Diploma, Bachelors Degree etc):
Tohu a-waho i ngā whare wananga? | Do you have any other qualifications/certificates/licences/or attended any courses? (Give details)
Reo | Languages

E kōrero ana i te reo Māori? Can you speak Te Reo Māori?

	Tick the level that applies to you:
Kākano/Beginner
Rito/Intermediate
Matatau/Fluent

E kōrero ana i ngā reo o te ao? | Can you speak any language other than Te Reo Māori and English? (if yes, please give details)
Pūkenga | Skills
Tēnā, whakamohio mai ōu ake pūkenga e hangai ana ki tēnei tūmomo mahi | Please describe the skills you hold which are relevant to the position applied for (e.g. for a typist – typing speed, word processing capability, shorthand capability, etc).
Mahi Hītori | Employment History
Present or most recent employer:
Pakihi | Organisation:
Tūranga | Job Title:
Mahi matua | Main Duties:
Hāora mahi | Number of hours worked per week:
Wā mahi | Length of service:
Mō te mahi tōtika mātou i te 'Privacy Act 2020' e āhei ana mātou ki te kōrero ki tō wāhi mahi me tō kaituku mahi hoki? | For the purposes of compliance with the Privacy Act 2020, do you consent to Sport Northland contacting your present employer for the purposes of reference checking?

Āe/YesKahore/No
Next most recent employer:
Pakihi | Organisation:
Tūranga | Job Title:
Mahi matua | Main Duties:
Hāora mahi | Number of hours worked per week:
Wā mahi | Length of service:
Wheako | Other relevant experience:
Tuhia nga taipitopito mō ētahi atu wheako e whai kiko ana | Please give details of any other experiences which may be relevant:
Kua mahi ano koe mo Sport Northland e hono atu ana i mua? | Have you ever worked or volunteered for Sport Northland before?

Āe/YesKahore/No
Kōrero mai | If yes, when?
He mahi tuarua kei a koe? | Do you have secondary employment?

Āe/YesKahore/No
Kōrero mai | If yes, please provide details:
Rewherī | Referees

Please provide the details of at least two referees.
Ingoa | Name

First NameLast Name
Ingoa pakihi | Organisation
Tūranga | Position
Nama Waea | Phone Number
Please enter a valid phone number.
Īmera | Email
Ingoa | Name

First NameLast Name
Tūranga | Position
Nama Waea | Phone Number
Please enter a valid phone number.
Īmera | Email
Ingoa | Name

First NameLast Name
Tūranga | Position
Nama Waea | Phone Number
Please enter a valid phone number.
Īmera | Email
Ka whakaae ahau ki Sport Northland ki te rapu kōrero, kōrero tuhi ranei mo au mai i nga mangai o aku rangatira o mua me nga kaitautoko rānei ki te whakamana i nga korero i rapuhia kia tukuna atu ratou ki Sport Northland mo nga take kia kitea ai taku pai mo te wāhi ka tono ahau. Kei te marama ahau ko nga korero i tae mai ki a Sport Northland he mea whakawhirinaki hei rauemi arotake, kaore hoki e whakaaturia mai ki ahau.

I First NameLast Name consent to Sport Northland seeking verbal or written information on a confidential basis about me from representatives of my previous employers and/or referees and authorise the information sought to be released by them to Sport Northland for the purposes of ascertaining my suitability for the position for which I am applying. I understand that the information received by Sport Northland is supplied in confidence as evaluative material and will not be disclosed to me.

SignatureDate
Ngā Pātai Whānui | General
Are you prepared to work overtime if required?*

Āe/YesKahore/No
Are you prepared to work on the weekend if necessary?*

Āe/YesKahore/No
Are you prepared to work outside of 8.30am to 5pm if necessary?*

Āe/YesKahore/No
E tātari tonu ana koe mō ētahi whakapae taihara? | Are you awaiting the hearing, determination or sentence on any criminal charges?*

Āe/YesKahore/No
Kei a koe ētahi ongā hara taihara o mua? Atu i ngā mea i huna nā te 'Criminal Records (Clean Slate) Act 2004' | Do you have any previous convictions excluding those concealed by the Criminal Records (Clean Slate) Act 2004?*

Āe/YesKahore/No
Kei a koe ētahi atu mea i te aroaro te kōti kahore he mea taihara e tātari tonu ana kia whakarongo, kia whakatau kia tukana atu rānei? | Do you have any other matters before the court not criminal in nature awaiting hearing, determination or disposal?*

Āe/YesKahore/No
Kua whakapeau e koe mai i te kōti? | Have you been the subject of a diversion ordered by the Courts?*

Āe/YesKahore/No
E whakāe ana koe ki te tirotiro i ngā pirihimana me te kōrero e tohatohaina ana ki a Sport Northland? | Do you agree to undergo a Department of Courts / Police screening check and the information being released to Sport Northland?*

Āe/YesKahore/No
Kei te rite koe ki te hāpai i ngā katoa, taputapu mea rāngi e whakamahia ana i te mahi nei? | Are you prepared to handle all products, materials, or equipment used in the industry?*

Āe/YesKahore/No
Kei a koe he raihana motoka? | What drivers licence do you currently hold?:*
Kei a koe ētahi tohu demerit? | Do you have any demerit points or endorsements?*

Āe/YesKahore/No
Kōrero mai | If yes, please detail:
Kei a koe he hoa rangatira, whanaunga i Sport Northland me tenei momo mahi? | Do you have a spouse, partner, relative or household member working at Sport Northland or elsewhere in the industry?*

Āe/YesKahore/No
Kōrero mai | If yes, who? and where?
He aha ngā mea e pai ana ki a koe, ngā mea whakangahau ngā hākinakina, ngā karapu me ngā mahi a te hapori? | What are your interests/hobbies/sports/clubs or community activities?*
Hauora | Medical Information
Do you smoke/vape?*

Āe/YesKahore/No
E whakāe ana koe ki te tirotiro i te hauora mena ka hiahiatia? | Do you agree to undergo a medical examination if required?*

Āe/YesKahore/No
Kua raru koe i tētahi wharanga e hiahia ana he whakatā i tō mahi? | Have you ever suffered from any injury requiring time off work?*

Āe/YesKahore/No
Kōrero mai | If yes, please provide details:
Kei te mohio koe i tētahi ahuatanga o naianei, o mua rānei ka he ki tō kaha ki te mahi tēnei mahi, ki te raru rānei i ētahi atu o ngā kaimahi? | Do you have any known condition, current or previous illness or injury, which may affect your ability to effectively carry out the functions and responsibilities of the position applied for or that could put other employees at risk?*

Āe/YesKahore/No
Kōrero mai | If yes, please provide details:
Kua oti i a koe tētahi kereme ACC mo ngā aitua kia pa ki tō kaha ki te kawe i ngā mahi katoa? | Have you made any ACC or Workers Compensation claims for accidents or injuries which may affect your ability to carry out the duties and responsibilities of the position applied for?*

Āe/YesKahore/No
Kōrero mai | If yes, please provide details:
Kua raru koe i tētahi ahua o te mate mahi? | Have you ever suffered from any form of Occupational Over Use Syndrome?*

Āe/YesKahore/No
Kōrero mai | If yes, please provide details:
Cover Letter and CV
Upload your Cover Letter here:

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Upload your CV here:

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Kei te whakāe koe ki te pūpuri a Sport Northland i ō kōrero ki tēnei pepa e mātau tāu e tika ana mo ētahi atu mahi i Sport Northland? | Do you consent to Sport Northland retaining the information contained in this application form for the purposes of considering your suitability for any other position which may arise with Sport Northland in the future?*

Āe/YesKahore/No
Mena ka tutuki koe tēnei mahi, āhea koe tīmata ai? | If your application is successful, when could you commence employment?

MonthDayYear
Date
Whakapuakitanga | Declaration
I, First NameLast Name declare that;

Mōku ake, ko ngā korero o tēnei puka me ngā mea e piri ana he pono;Kei te mārama ahau mena he kōrero rūkahu, kōrero huna rānei kahore ahau e mahi mena ka tukuna ki ahau ka whakaoti koutou taku mahi;Ko ngā kōrero toka e pa ana ki taku hitori hauora ka ngaro pea taku mana mō tētahi tautoko mai i a ACC. (Kei te mārama ahau ko ngā tono mahi mena ka tukuna ahau ko ngā tono, mahi mena ka tukuna he here ki te whiwhi taku whakawhiwhinga hauora).

To the best of my knowledge the information provided in this application and in any resume enclosed is accurate. I understand that if any false or misleading information is given, or any material fact suppressed, I will not be employed, or if I am employed, my employment will be terminated. Any false information given in relation to my medical history may result in my loss of entitlement for any compensation from Sport Northland’s contracted accident insurance provider and/or ACC. (I further understand that any offer of employment if made is conditional on my obtaining a full medical clearance through the Company’s pre-employment medical).

SignatureDate
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Pukatono Tūranga | Application for Employment

Mōu | About You

Ō Pārongo Whakapā | Contact Details

Te Mana Mahi Ture | Legal Work Status

Mātauranga | Education

Reo | Languages

Pūkenga | Skills

Mahi Hītori | Employment History

Present or most recent employer:

Next most recent employer:

Wheako | Other relevant experience:

Rewherī | Referees

Ngā Pātai Whānui | General

Hauora | Medical Information

Cover Letter and CV

Whakapuakitanga | Declaration