BHJ Employment Application Form

  • Application Form

    Fill the form below accurately indicating your potentials and suitability to job applying for.
    • Personal details 

    • Purpose: This information is to be collected for the purpose of assessing your suitability for employment with the business. All information supplied will only be used in accordance with the Privacy Act.

    •  -
    • If your application is successful, when could you commence employment?
       - -
    • Are you legally entitled to work in New Zealand?*
    • Do we have your consent to do a police check on you?
    • Are you prepared to work:
    • Do you have, or are you aware of any likely commitments, which may prevent you from attending work during normal work hours or affect your availability for overtime?
    • Have you been convicted of a criminal offence?*
    • Are you awaiting the hearing of any charges in a civil or criminal court of law?*
    • Education & Training 
    • Upload a File
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    • Employment History 

    • Please complete the following Employment History fields if it is not included in a CV you have uploaded.

    • Have you ever been employed by this business?
    • Do you have any friends or relations working for this business?
    • Rows
    • Rows
    • Medical 

    • The information requested in this section is for health and safety related reasons, including the need to ensure no potential or existing staff is placed at risk in the workplace. Please complete the following:

    • Have you been on ACC in the past two years?*
    • Have you had any injury or medical condition including:*
    • Are you, at present, receiving medical treatment and / or medication?*
    • Do you have any other injury, illness or condition which may affect your ability to effectively carry out the functions and responsibilities of the position applied for?*
    • Do you agree to attend a nominated Registered Medical Practitioner for a health assessment and drug testing prior to being offered a position at BHJ New Zealand Limited?*

    • Please complete the following if you have suffered from, or are a carrier of, any of the following notifiable diseases:

    • Section A – Infectious Diseases Notifiable to a Medical Officer of Health and Local Authority

    • Acute gastroenteritis ***
    • Campylobacteriosis*
    • Cholera*
    • Cryptosporidiosis*
    • Giardiasis*
    • Hepatitis A*
    • Legionellosis*
    • Listeriosis*
    • Meningoencephalitis – primary amoebic*
    • Salmonellosis*
    • Shigellosis*
    • Typhoid and paratyphoid fever*
    • Yersiniosis*

    • Section B – Infectious Diseases Notifiable to Medical Officer of Health

    • Acquired Immunodeficiency Syndrome*
    • Anthrax*
    • Arboviral diseases*
    • Brucellosis*
    • Creutzfeldt-Jakob disease and other spongiform encephalopathy’s*
    • Diphtheria*
    • Enterobacter sakazakii invasive disease*
    • Haemophilus influenzae b*
    • Hepatitis B*
    • Hepatitis C*
    • Hepatitis (viral) – not otherwise specified*
    • Highly Pathogenic Avian Influenza (HPAI)*
    • Hydatid disease*
    • Leprosy*
    • Leptospirosis*
    • Malaria*
    • Measles*
    • Mumps*
    • Neisseria meningitides invasive disease*
    • Pertussis*
    • Plague*
    • Poliomyelitis*
    • Rabies*
    • Rheumatic fever*
    • Rickettsia diseases*
    • Rubella*
    • Severe Acute Respiratory Syndrome (SARS)*
    • Tetanus*
    • Viral haemorrhagic fevers*
    • Yellow fever*

    • Section C –Notifiable to the Medical Officer of Health

    • Taeniasis*
    • Cysticercosis*
    • Trichinosis*
    • Decompression sickness*
    • Lead absorption equal to or in excess of 10µg/dl (0.48µ mol/l) ****
    • Poisoning arising from chemical contamination of the environment*
    • Notifiable Diseases Under Tuberculosis Act 1948 - Notifiable to the Medical Officer of Health: Tuberculosis (all forms)*
    • Declaration 
    • Should be Empty: