PAKnSAVE Application Form

Job Application For PAKnSAVE Whangarei

The completion of this form does not indicate that there is any obligation on the Company to employ / engage you. Please complete the form to express your interest in working with us.
Full Name*

First NameMiddle NameLast Name
I identify as *
Current Address

Street Address

Street Address Line 2

City

Post CodeCountry
Email Address*
Was your legal age at your last birthday over 16?

YesNo
Phone Number

Area Code Phone Number
Mobile number

e.g 021Phone Number
Your legal entitlement to work in New Zealand*

I am a NZ citizenI hold a NZ Residence PermitI hold a Work PermitI hold a Student Permit
Please provide Work/Student Permit number, expiry and conditions if applicable.
Please note: Failure to have clear evidence of being legally able to work in New Zealand or providing false information or misrepresenting your eligibility to work in NZ may result in any employment being terminated or an offer of employment withdrawn.
PLEASE NOTE: YOU ARE REQUIRED TO PROVIDE EVIDENCE OF YOUR LEGAL RIGHT TO WORK IN NZ WHERE APPROPRIATE.
Applying for Position*
Start date

DayMonthYear
Upload Resume*

Upload a File

Cancelof

EMPLOYMENT HISTORY
Please list your previous work history with dates employed, position held and reason for leaving.
Please list any reasons for breaks in your employment
GENERAL INFORMATION
Have you ever worked for this company or an associated company before?

YesNo
Do you have a spouse, partner, relative or household member working here or elsewhere in the industry?

YesNo
If yes please indicate below whom they are, where they work and the position they hold.
Are you prepared to handle all products, materials or equipment used in the industry?

YesNo
If no, please state why.
e.g. alcohol and meat products
What transport arrangements do you have, to attend your place of employment?
e.g. bus, car, walk
Do you have a current drivers licence?

YesNo
If yes, what class/s? including endorsments
Drivers licence number

MEDICAL

(it is important that all questions in this section are answered fully)
Have you had an injury or medical condition caused by gradual process, disease or infection for example hearing loss, allergy or sensitivity to chemicals, exposure to asbestos, skin irritants or repetitive strain injuries that may be aggravated or further contributed to by the tasks of this job?

YesNo
If yes, please provide details
Do you suffer from any injury, ailment or other disability (mental or otherwise)which may adversely affect your regular attendance at work or adversely affect your work performance?

YesNo
If yes, please provide details
Do you consent to undergo a medical examination if requested as a condition of your employment?

YesNo

REFEREES: (Please provide the following details for at least two referees whom maybe contacted for a referance. We would prefer one to be a direct manager)
Referee 1: Please provide details of Name, relationship to you, the position / job title they hold and a contact phone number.
Referee 2: Please provide details of Name, relationship to you, the position / job title they hold and a contact phone number.
Referee 3: Please provide details of Name, relationship to you, the position / job title they hold and a contact phone number.
By clicking Submit at the end of this application form, I declare that to the best of my knowledge information provided in this application and in any resume enclosed is accurate and 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. I further understand that any false information given in relation to my medical history with regards to gradual process, disease or infection can result in my loss of entitlement for any compensation from The Company Work Place Accident Insurance. I also consent to the company retaining the information contained in this application form for the purposes of considering my suitability for any other position which may arise with this company in the future
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Job Application For PAKnSAVE Whangarei