Application Form (All fields are required)
1. Advertising Medium:
Please indicate where you saw the advertisement for this position.
2. Please explain 'Other' from Question 1 (if not applicable please type N/A) :
3. Work Status:
Are you legally entitled to work in New Zealand?
4. Qualifications:
Please indicate which of the following qualifications you have attained
5. Specific Skills:
Please list any specific skills or attributes you have relevant to this position that have not been identified in your CV.
6. Desktop skills:
Are you familiar with Windows 7 or Microsoft 2010?
7. Drivers Licence:
Do you have a valid drivers licence?
8. Drivers Licence:
If yes, what classes do you hold?
9. Drivers Licence:
Do you have any pending driving offences, loss of demerit points, if so please detail?
10. Health:
Please declare any current health or physical matters which may be relevant to your ability to perform in the intended role.
11. Convictions:
In accordance with the Clean Slate Act: have you ever been convicted of an offence or have charges pending in New Zealand or another country?
12. Convictions:
If you answered yes to the previous question, please provide more information.
13. Employment:
If you have you previously worked for the Whakatane District Council please list any former roles.
14. Employment:
Please list any positions with the Whakatane District Council that you have applied for over the last two years?
15. Employment:
Please indicate if you have a relative/close friend or household member currently employed by Whakatane District Council, or in a situation that could cause a conflict of interest if you are appointed.
16. Employment:
Please indicate if you have entered into bankruptcy or any material accommodation with creditors?
17. Security Checks:
If required, do you consent to the Whakatane District Council undertaking the following security checks? Criminal History/Police Checks, Drivers Licence, Credit Checks, Dismissal Register, Other (if relevant)
18. Referee's:
Please give names and contact phone numbers of at least two (2) work related referees, preferably where there has been a direct reporting relationship (i.e: Supervisor/Manager).
19. Referee's:
Following the interview process; do you consent to the Whakatane District Council seeking verbal or written information on a confidential basis about you from the above referees for the purposes of ascertaining my suitability for this position?
20. Medical Check:
If selected for a role: would you be prepared to undergo a pre-employment drug test and or medical check
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