Bayonne Construction Employment Application

Job Application

The completion of this form does not indicate that there is any obligation for the company to engage the applicant in employment. Purpose: This information is collected for the purpose of assessing your suitability for employment at Bayonne Construction (1996) Ltd.
Position Applying For*
Name*

First NameLast Name
Preferred Name
Birth Date*

DayMonthYear
Phone Number*

Area CodePhone Number
Date of Application*

DayMonthYear
Email Address*
example@example.com
Current Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Employment Questionnaire
Can you pass a drug and alcohol check?*

YesNo
Do you have reliable transport to get to and from work?*

YesNo
Have you been convicted or charged with a criminal offence or have any pending charges?*

YesNo
Does any of your family (including partner) work for Bayonne?*

YesNo
Do you have commitments that may prevent you from attending work in the future?*

YesNo
Do you have any secondary employment?*

YesNo
Drivers Licence Information
Do you have a current NZ driver's licence*

YesNo
Driver Licence No.
Licence Type

FullRestrictedLearners
Licence Classes

124WTRF
Do you have any special conditions on your licence?

YesNo
If you have ticked yes, please explain
Do you have any demerit points?

YesNo
If you have ticked yes, how many?
Do you have any licence cases pending?

YesNo
If you have ticked yes, please explain
Do you give Bayonne Construction permission to check your licence information with NZ Driver Check?

YesNo
Do you have an overseas licence? *
Right to Work
Right to work type (NZ Citizens may be required to provide evidence of this eg: Birth Certificate, Passport or Affidavit)*

NZ CitizenPermanent ResidentResident VisaWork VisaOther
Please provide copy and details of any visa conditions (documents can be attached at the end of this document)
Fitness to Work
Our field roles involve demanding labour in various weather conditions. Do you have the physical and mental ability to undertake this work?*

YesNo
Do you have any medical condition, injuries, restricted movement, allergies, or health issues that may prevent you from being at work, may place yourself or others at risk, or prevent you from performing your duties in a safe manner?*

YesNo
If you have ticked yes, please explain
Do you have any hearing, eyesight, respiratory, diabetes or other issues we need to be aware of?*

YesNo
If you have ticked yes, please explain
Have you ever suffered from Repetitive Strain Injury (RSI) or Occupational Overuse Syndrome (OOS)?*

YesNo
If you have ticked yes, please explain
Are you taking any medications or receiving treatment that may impair your ability to perform tasks or affect outcome of drug and alcohol checks?*

YesNo
If you have ticked yes, please explain
Have you ever had a workplace accident or injury which required an ACC claim?*

YesNo
If you have ticked yes, please explain
Do you agree to Bayonne checking your previous claims history with ACC?*

YesNo
Do you agree to participate in professional annual health monitoring?*

YesNo
Do you agree to future additional drug and alcohol checks?*

YesNo
Are there any other issues which may affect your fitness to work?*

YesNo
If you have ticked yes, please explain
Employment History
Company Name
Duration
Position Held and Duties
Reason for Leaving
Company Name
Duration
Position Held and Duties
Reason for Leaving
Company Name
Duration
Position Held and Duties
Reason for Leaving
Can we contact your most recent employer?*

YesNo
Qualifications/Training
Do you have any training, qualifications, or education relevant to the position being applied for. Including any traffic management, first aid, construct safe, driver or health and safety training?
Do you consent to Bayonne Construction checking your NZQA record of achievement?*

YesNo
General Questions
You will be required to wear Bayonne issue PPE. Is there any reason you cannot wear the equipment required for the job? If unsure what this involves, please discuss with your interviewer.*

YesNo
If you have ticked yes, please explain
Are you able to work the occasional Saturday/Sunday or night work when required?*

YesNo
If successful, when are you available to commence work with Bayonne Construction?*

DayMonthYear
Date
Do you have any planned holidays where you will need to take time of work??*

YesNo
If you have ticked yes, please give us the dates
References
REFERENCE 1: Name*
Company and Role*
Relationship to you*
Phone Number*

Area CodePhone Number
REFERENCE 2: Name
Company and Role
Relationship to you
Phone Number

Area CodePhone Number
REFERENCE 3: Name
Company and Role
Relationship to you
Phone Number

Area CodePhone Number
CV and Cover Letter
Cover Letter
Upload Your CV and any other documents you think will be useful including Right to Work documents

Cancelof
Declaration

I declare that the information provided in this application is true, complete, and correct. I understand that if I have provided false or misleading information that I may not be offered employment, or if employed I may be dismissed with immediate effect. I consent to Bayonne assessing my ability to complete the duties of the role including interviews, medical and health checks, drug and alcohol testing, referee checks, criminal checks, group assessment and observations. If successful, this form and information gathered shall be kept on your personnel file.
Name*

First NameLast Name
Signature*

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Date*

DayMonthYear
Date
Should be Empty:

Job Application

Employment Questionnaire

Drivers Licence Information

Right to Work

Fitness to Work

Employment History

Qualifications/Training

General Questions

References

CV and Cover Letter

Declaration