FAIRWEATHERS APPLICATION FORM
Application for Employment
Full Name
*
Address
*
Phone Number
*
Date Of Birth
*
Email Address
*
Do you have a current driver's license
*
Yes
No
If yes, please specify by selecting one of the below
*
Full License
Restricted License
Learner License
If you have a Full License, are you willing and able to drive a courtesy van for our customers?
*
Yes
No
Venue Applying for?
*
Please Select
Richmond, NSN
Blenheim, BHE
Halswell, CHC
Belfast, CHC
Beckenham, CHC
Islington, CHC
Ashburton
Greymouth
OTHER
Date Applied
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-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Position Applied for?
*
Work Required (Choose one)
*
Full Time
Part Time
Casual
Days and Times Available to work (Tick)
Rows
BOTH
AM
PM
MON
TUES
WED
THUR
FRI
SAT
SUN
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Health and Physical Particulars
Have you ever suffered any type of personal injury caused by previous work. Such as gradual process, disease, or infection?
*
Yes
No
If yes, please specify
Have you ever had any injury, which is likely to contribute to a work-related gradual process injury, disease, or infection?
*
Yes
No
If yes, please specify
Have you ever had any serious illness, operation or accident, or condition that could hamper your work in this position?
*
Yes
No
If yes, please specify
Have you currently or recently been prescribed any medication?
*
Yes
No
If yes, will your medication or your condition potentially hamper your work in this position?
*
Yes
No
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If yes, please specify
More Details
Please List Your Qualifications (Certificates to be supplied with this application)
*
Have you ever been charged with any offences? If ‘yes’, please provide details and dates:
*
Do you have any legal proceedings pending? If ‘yes’, please provide details:
*
Have you been declined a manager’s license or had your license removed? If 'yes', please specify why.
*
Do you have a NZ General Manager’s certificate for the purpose of the Sale and supply of Liquor?
*
Yes
No
Are you legally entitled to work in New Zealand?
*
Yes
No
Do you have a work permit?
*
Yes
No
If yes when does this expire? Work permits or evidence of authority to work in New Zealand may be requested.
Do you have any credit issues we need to be aware of?
*
Yes
No
If yes, please specify
Do you have any pre planned holidays or sporting commitments?
*
Yes
No
If yes, please provide dates and details.
Please supply the names and telephone numbers of at least three referees. Please provide last employer and at least two other previous employers.
*
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Employment Record: All prior positions must be listed
Previous Employer -1
Job Title
Date employed from
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Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Date employment ended
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Reason for leaving?
Previous Employer - 2
Job Title
Date employed from
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Date employment ended
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Reason for leaving?
Applicants Full Name and Signature
By signing this application, I affirm that all information provided is true and accurate to the best of my knowledge. I understand that any falsification or omission of details may adversely affect my consideration for employment or, if discovered after hiring, may lead to termination of employment.
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