Application For Employment Form (Page 2 of 3) in pdf

Application For Employment Form Page 2

Legal Requirements

Are you legally entitled to work in NZ?

Yes / No

If yes, are you legally entitled to work because:

(a) You are a NZ citizen?

Yes / No

(b) You have a Work Visa?

Yes / No

____________________________________________________________________

(d) If yes to (b), please attach a copy of your work visa with this application:

Expiry date of Work Visa: ____________________________

Employment History

(start with the most recent position)

Name and

May we contact

From (date) to

Position and main

Reason for

Address of

this employer for

(date)

duties

leaving

Employer

a reference?

Yes / No

Referees

(Please note: two must be supplied)

Name

Contact Number

Relationship

Medical

: The Health and Safety in Employment Act requires us to ensure the safety of employees at work.

Because some of the tasks may aggravate a prior injury or disposition, you are asked to answer the following

questions. Do you have any medical conditions or substance dependency which may affect your ability to

effectively carry out the functions of employment or may be further aggravated by the functions and

responsibilities of employment including: Medical Questions continued on next page.

Application For Employment Form Page 2