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Applications close: 6 months from now - 16/07/2025.

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Mrs

Miss

Or Other Preferred Title:

Full Name:*

Birth Name (if applicable):

Are you known by any other name(s):

YES

Address:*

Please start typing your address and select from the list

Street ^*

Suburb ^*

City ^*

Region ^*

Post Code ^*

Country ^*

Email Address:*

Contact numbers:

Work Phone

Home Phone

Mobile Phone

Identity Verification, Criminal Record and Right to Work

Immigration information

Are you a citizen of a country other than New Zealand?*

YES

Have you ever had a criminal conviction?*

YES

(A board may not employ or engage a children's worker who has been convicted of an offence specified in Schedule 2 of the vulnerable Children Act 2014. The clean Slate Act does not apply to schedule 2 offences.)

Have you ever received a police diversion for an offence?

YES

Have you ever been discharged without conviction for an offence?

YES

Do you have a current New Zealand driver's license?

YES

Have you ever been discharged without conviction for an offence which resulted in temporary or permanent loss of license, or imprisonment?

YES

Are you awaiting sentencing or do you have charges pending?

YES

In addition to other information provided are there any other factors that we should know to assess your suitability for appointment and your ability to do the job?

YES

Have you ever been the subject of any concerns involving child safety?

YES

Have you had any injury or medical condition caused by gradual process, disease or infection, such as occupational overuse syndrome which the tasks of this position may aggravate or contribute to?

YES

Attendance Record

Do you suffer from any illness or injury or other disability that may adversely affect your performance, regular attendance, personal safety , or safety of others?*

YES

Do you have any commitments or interests(s) that may interrupt your regular attendance at work?*

YES

Educational Qualifications

Secondary School:

University:

Other:

Work History

Please list your work experience for the last five years beginning with your most recent position. Please explain any gaps in the employment. If you were self-employed, give details. Attach additional sheets if necessary.

Period worked:

Employer's name:

Position held:

Reason for leaving:

Period worked:

Employer's name:

Position held:

Reason for leaving:

Period worked:

Employer's name:

Position held:

Reason for leaving:

Period worked:

Employer's name:

Position held:

Reason for leaving:

Referees

Please list TWO Employment referees whom we may contact for a personal reference.

Name * Association * Phone *

Cover Notes:

Cover Letter: *

Curriculum Vitae: *

Please ensure you have completed all required questions marked with an asterisk to apply.

You will receive a successful notification if you have applied correctly.

If you have not received this message, kindly review the questions and resubmit your application

I CONFIRM that the information provided above is true and correct.

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Identity Verification, Criminal Record and Right to Work

Immigration information

Attendance Record

Educational Qualifications

Work History

Referees