Name of Employer 1
In accordance with company policy and/or at the direction of the company or authorised person do you agree to use/wear protective equipment?
Yes
No
Position Held
Referee’s Name
Referee’s Name
If yes, give brief details
Contact details - Phone
Contact Email
Name:
*
Company
Contact details - Email
Are you awaiting hearing of any charges for driving offences?
Yes
No
Contact No.
*
Date of Birth
Have you at any time taken action against a current or former employer in order to resolve an employment dispute, including personal grievance action or other employment relationship problem.
Yes
No
Do you agree to the medical examination and the company holding this information?
Yes
No
The position applied for requires that personal protective equipment be used/worn while carrying out tasks associated with this postion. Are you aware of any reason why you may not be able to use/wear the equipment?
Yes
No
Length of Service: (From - To)
Are you a member of a territorial force unit or volunteer fire brigade?
Yes
No
Contact details - Phone
Reason for Leaving
Referee’s Name
Referee’s Occupation/Position
Position you reported to (eg your Manager/Supervisor):
Length of Service: (From - To)
Position Held
Do you currently have demerit points?
Yes
No
Address
If yes, please give details:
By entering your name here, you are electronically signing the form
*
Contact details - Email
Reason for Leaving
Do you have a current drivers licence?
Yes
No
Have you previously applied to Wilson Contractors for a job?
Yes
No
Position you reported to (eg your Manager/Supervisor):
Referee’s Occupation/Position
Address
Position applied for
Have you previously been employed in this industry?
Yes
No
If yes please specify:
Contact details - Email
Licence No
Address
Qualifications/Standard of Achievement:
If Yes How Many
How many days absence in your last 12 months of employment were stated by you or a medical practitioner to be due to sickness, injury and/or accident?
0-2
3-5
6-10
11-15
16-20
>20 days
If yes, what class?
Reason for Leaving
Do you have or are you aware of any likely commitments which may prevent you from attending your place of employment during normal work hours or affect your availability for overtime (eg sports, hobbies, special interests, education, training)?
Yes
No
Thank you for contacting us! If needed, you will hear back within 48-72 hours.
Do you intend to engage in other paid or voluntary work whilst employed in this position?
Yes
No
Name of Employer 2:
Do you have a spouse, partner, relative or household member working in this company or elsewhere in the industry?
Yes
No
ADDITIONAL INFORMATION - Do you have any additional information you consider relevant to the organisation’s decision-making concerning hiring you for this position? For example, achievements, interests, aspirations, one-off commitments (e.g. for which you will require leave) or other background information pertinent to this position etc. If so, please attach all such information to this application form.
We were unable to upload your file. Please ensure your file is 10MB or smaller in size.
Have you ever been charged with or convicted of a criminal offence?
Yes
No
Name of Employer 3:
Company
Are you awaiting the outcome of any police investigation
Yes
No
If yes, what Class?
Length of Service: (From - To)
If your application is accepted, approximately when could you commence employment?
You should provide complete information for each question, unless otherwise advised, regardless of whether you consider it relevant to the position for which you have applied. Failure to complete this form in manner required may result in your application being declined.................................................................................................................................. COLLECTING AND HOLDING PERSONAL INFORMATION: The information you provide on this application for employment form will be collected and held by Wilson Contractors Ltd. PURPOSE: This information is collected for the purpose of assessing your suitability for employment with Wilson Contractors Ltd (this may include subsequent changes in employment within the organisation). If your application is successful this form will be retained on your personnel file. If unsuccessful it, along with your other application papers, will be destroyed after three months, unless you agree otherwise...... EDUCATION AND QUALIFICATION: Name of Education organisation, years attended of highest qualification achieved
Do you have the legal right to work in New Zealand, either entitlement to permanent residence or a valid work permit? (Evidence will be required if you are interviewed for the position.)
Yes
No
Contact details - Phone
Address
Position Held
Name of Applicant:
*
Position you reported to (eg your Manager/Supervisor):
Company
Referee’s Occupation/Position
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