APPLICATION FOR EMPLOYMENT

Role you are applying for

First names

Last name

Ethnicity

Are you known by any other names?

Phone

Address

Do you have a current drivers licence?

Licence Class

Licence Expiry Date

Are there any restrictions on you taking up employment in Alexandra or Tāhuna, New Zealand?

If selected, are there any restrictions on you attending an interview in Alexandra, New Zealand? (If yes, please provide details)

Employment History

1. Name of Employer

Address of employer

Job title and duties

Reason for leaving

Notice required in current role

2. Name of Employer

Address of employer

Job title and duties

Reason for leaving

3. Name of Employer

Address of employer

Job title and duties

Reason for leaving

4. Name of Employer

Address of employer

Job title and duties

Reason for leaving

Current Membership of Professional bodies

Please note any professional bodies you are a member of or are registered with.

Other Employment

Please note any other employment you would continue with if you were to be successful in obtaining this position.

References

Please note the names and addresses of two persons from whom we may obtain both character and work experience references.

1. Name

Phone

Company and in what capacity do you know them? i.e Manager/peer

2. Name

Phone

Company and in what capacity do you know them? i.e Manager/peer

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