Name

First Name

Last Name

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Are you legally entitled to work in New Zealand?

Yes

No

If you are NOT a New Zealand citizen, do you have a work visa?

Yes

No

N/A

When are you available from to start work?

MM

DD

YYYY

We operate 7 days a week, please indicate which days you are available to work.

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Are you currently in Wanaka?

Yes

No

How long do you intend to stay in Wanaka?

Less than 3 months

3 - 6 months

6 - 12 months

Over 12 months

I live here permanently

Start date

MM

DD

YYYY

End date

MM

DD

YYYY

Start date

MM

DD

YYYY

End date

MM

DD

YYYY

Start date

MM

DD

YYYY

End date

MM

DD

YYYY

CRIMINAL CONVICTIONS - In New Zealand, under the Criminal Records (Clean Slate) Act 2004, you are not required to disclose certain criminal convictions if you meet all the conditions of the Act. This section is applicable only if the nature of the job requires it, and such inquiries are compliant with the Criminal Records (Clean Slate) Act 2004 and the Human Rights Act 1993.

Do you have any criminal convictions that you are legally required to disclose, or any charges pending?

Yes

No

HEALTH AND FITNESS FOR THE JOB - The following questions are asked to determine whether you are able to perform the intrinsic duties of the job and whether any reasonable accommodations are required. Note: You are not obliged to disclose medical conditions unless it directly affects your ability to perform job-related tasks, or unless you choose to disclose for the purpose of seeking reasonable accommodations.

Do you have any medical conditions that may affect your ability to perform the role you are applying for?

Yes

No

NEGATIVE EMPLOYMENT HISTORY - You are not obliged to disclose any information regarding previous disciplinary processes if they are not relevant to the role you are applying for. However, you may be asked about your disciplinary history in previous employment if it is relevant to the requirements of the job for which you are applying.

Have you every been subject to a disciplinary process in a previous role that is relevant to the position yu are applying for?

Yes

No

By checking the box below, I declare that the information provided in this application is accurate and complete to the best of my knowledge and I understand that any false or misleading information may be grounds for not hiring me or for dismissal if I am employed. I acknowledge my rights under the Privacy Act 2020 regarding my personal information *

Confirmation of declaration.