Recruitment Application Form

  • Online Employment Application

    New World Greenmeadows,9 Gloucester Street, Napier HB
  • Todays Date:
     - -
  • Full Time or Part Time

  • Personal Information:

    Section 1
  •  -
  •  -

  • General:

    Section 2
  • Are you a NZ citizen?
  • If no, do you have permanent residence? (evidence must be provided as prove of claim)
  • If no, do you have a valid work permit? (evidence must be provided as prove of claim)
  • Do you have a student visa / work permit
  • Visa expiry date
     - -
  • If 'YES' is selected a copy of valid visa or permit and front page of passport must be attached to application form please.
  • Have you been charged or convicted with a criminal offence in the last seven years?
  • Do you consent to undergoing a pre-employment drug test*
  • Are you currently engaged in other paid employment?
  • Will you remain employed with this other company while employed in this position?

  • Skills/Qualifications:

    Section 3

  • Previous Employment:

    Section 4
  • May we contact previous employers and/or references given?
  • Start Date
     - -
  • End Date
     - -

  • References:

    Please give details of referees whom you authorise us to contact:

  • Health

    Section 5
  • Are you allergic to, or have sensitivity to any substances or chemicals?(For example: soap powders, flour dust, cleaning materials etc.)
  • Have you ever suffered any back injury or back strain?
  • Have you ever suffered from any overuse injuries eg: RSI or OOS?
  • Have you ever made a claim under the ACC scheme?
  • How many days absence due to sickness have you claimed in the last three months of employment?

  • Do you have a problem performing any of the following tasks?

  • Standing for long periods of time
  • Kneeling
  • Lifting from floor to shelf
  • Climbing stairs/ladders
  • Would you wish to be considered in the future to manage other team members?

  • Cover Letter & Resume (Optional):

  • Upload a File
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  • Upload a File
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  • Declaration:

  • I have personally completed this application for employment and declare that the information provided in this application (and resume
    where provided), is correct.

    I understand that should I be successful in my application, falsification or deliberately misleading information, or any material suppression of information will be grounds for instant dismissal.

    I also understand that any false information given in section 5, the medical portion of this form, may result in my loss of entitlement for any compensation from ACC.

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