• Pukatono Tūranga | Application for Board Member

    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 the board of Sport Northland.

  • Mōu | About You

  • Ō Pārongo Whakapā | Contact Details

  • Format: (000) 000-0000.
  • Format: (000) 000-0000.

  • Te Mana Mahi Ture | Legal Work Status

  • Reo | Languages

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

  • Pūkenga | Skills

  • Mahi Hītori | Employment History

  • Present or most recent employer:

  • Mō te mahi tōtika mātou i te 'Privacy Act 1993' 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 1993, do you consent to Sport Northland contacting your present employer for the purposes of reference checking?

  • Wheako | Other relevant experience:

  • Kua mahi ano koe mo Sport Northland e hono atu ana i mua? | Have you ever worked or volunteered for Sport Northland or an associated Regional Sports Trust before?

  • Rewherī | Referees

    Please provide the details of at least two referees.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.

  • 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      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.

     Pick a Date

  • Ngā Pātai Whānui | General

  • Are you available to attend monthly board meetings after hours from 5.30-8pm?*
  • E tātari tonu ana koe mō ētahi whakapae taihara? | Are you awaiting the hearing, determination or sentence on any criminal charges?*
  • 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?*
  • 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?*
  • Kua whakapeau e koe mai i te kōti? | Have you been the subject of a diversion ordered by the Courts?*
  • 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?*
  • 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?*

  • Cover Letter and CV

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  • Whakapuakitanga | Declaration

  • I,      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).

    Pick a Date

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